Adoption Application

UFBH is very careful about the proper placement of our basset hounds. In order to find the best match for you, please fill out the following form. All information collected on this form is for placement purposes only and will not be used for solicitation or sold to other lists.

Biographical Information

Last Name*

First Name*

Middle Name*

Address*

Address 2*

City*

State* (We accept applications from these states only.)

Zipcode*

Home Phone*

Work Phone*

Cell Phone*

Driver's License #*

Email*

Your Dog Experience

Have you owned a dog before? Yes No

Have you owned a basset hound before? Yes No

If you no longer have the dog(s), what happened to them?

Have you housetrained a dog before? Yes No

If necessary, are you willing to housetrain one now? Yes No Maybe

Have you ever attended formal obedience training classes? Yes No

If yes, what school did you attend?

What methods have/will you use to correct bad behavior in a dog?

Do you currently have any pets? Yes No

If yes, how many pets do you have?

Please list all your current pets. Using the form, fill in the blanks; press the 'Add Pet'
button and they will appear in the text area below. Follow the same steps for each pet.
Pet Name
Breed
Pet's Age
Gender
Spayed/Neutered?
Age they were spayed/neutered?

Your Current Pets

Current Veterinarian (Include a phone number)

May we contact your vet for a reference? Yes No

Your Physical Home & Basset Accomodations

In what type of home do you live?

If you marked 'other,' please explain.

Do you own or rent your home? Own Rent

If you rent, do you have landlord permission to own a dog? Yes No

Please list your landlord's name and phone number.

Do you have a fenced yard? Yes No

Do you have a doggie-door? Yes No

Do you have a swimming pool? Yes No

If yes, does your pool have a fence? Yes No

Where will the basset stay during the day?

Where will the basset sleep at night?

Your Lifestyle

Are there children in your household? Yes No

If yes, what are the ages of the children?

How many individuals live in your home?

How many hours will the basset be without human companionship at any one time?

If you marked 'more than eight,' please explain.

Why do you want a basset hound?

For which of the following reasons would you give up a dog? (Select all that apply.) Moving Not housetrained Divorce Gets too large Shedding Human allergies Escaping the yard Behavior problems Barking Increased work hours Aggressive New baby Does not get along with children Dog has medical problems Does not get along with other pets Children lose interest Would not give up
Other reasons not listed

What would you do if facing an unexpected vet bill over $1,000 for vet care required to
save your dog's life? (Select all that apply.) Pay with credit card Take out loan Refuse treatment Take to shelter Return to UFBH Ask UFBH for money Have dog euthanized Money is not an issue Arrange payment plan with vet
Other

Is there anyone in your family hesitant about owning a basset hound? Yes No

If yes, please explain.

Your Preferences

Which gender would you prefer for your basset? Male Female No preference

Do you have an age preference? Puppy Young Adult Adult Senior No preference

What traits would you like MOST in your basset hound? (Check all that apply.) Independent Easygoing Silly Serious Protective Quiet Playful Dependent Gentle Energetic Confident

What traits would you like LEAST in your basset hound? (Check all that apply.) Dominance Stubborn Tendency to escape Protective of food Not good with dogs Biting Has accidents indoors Plays rough Not good with cats Destructive chewing Digging Noisy Jumps up on people Aggressive with children Excessive shyness Counter-cruising

Additional Comments & Information

Additional Comments

How did you hear about UFBH?

May we contact you about events and other gatherings? Yes No

Terms for Application Submission

You must read and agree to the following terms before you will be allowed to 'sign' and submit your application.
All of the information provided is true and complete to the best of my/our knowledge. I/we understand that a UFBH representative will contact me/us to schedule an appointment for a home visit. I/we understand that a donation/fee will be required, should I/we adopt a basset hound from Utah Friends of Basset Hounds. In the event that, for any reason, the basset hound shall be incompatible with me/us and/or my/our family, I/we promise to return the basset hound to UFBH without charge.
I have read the legal statement above. I agree to the terms as they are written.
Please type your full legal name in the following field.