1. Are you 18 years of age or older?(Required) Yes No 2. Applicant Name (First & Last):(Required) 3. Street Address:(Required) 4. City(Required) 5. State(Required) 6. Zip Code(Required) 7. Additional Address Information (Apt No., PO Box, etc.)8. Will the dog be kept at the above address? *(Required) Yes No 8. Explain(Required) 9. Are you moving within the next 6 months? *(Required) Yes No 9. Explain 10. Preferred Phone Number:(Required)11. Secondary/Backup Phone Number:12. Preferred Email Address: *(Required) 13. Employment Status(Required) Yes No Name of your employer(Required) Retired/Other, please explain(Required) 14. Are you adopting this dog for yourself? *(Required) Yes No 14. Explain(Required) 15. Have you, a member of your household or immediate family ever applied to adopt a dog from us before? *(Required)(Required) Yes No 15. Explain(Required) 16. Have you recently applied to adopt from any other rescue groups? *(Required) Yes, Org Name(s) No Organization Name 17. Have you had prior experience with beagles or other scent hound breeds? *(Required) Yes No 18. What is your main reason for adopting a dog? *(Required) Hunting Dog Companion Family Pet Watchdog Playmate For Child Breeding Other Other(Required) 19. How many adults live at the address where the dog will be kept?(Required)112345More20. Do you have children living at home or children who regularly visit you? *(Required) Yes No 21. If yes to above, please list all of their names and ages (if visitor only, please identify with the word "visitor"):22. Do you suspect anyone in your household is allergic to animals? *(Required) Yes No Unknown 23. In what type of dwelling will the beagle reside? *(Required) Single Family Home Townhouse Apartment Duplex Other Other 24. Do you own or rent your home? *(Required) Own Rent 25. If you rent, do you give your consent for HBHR to contact your landlord to confirm authorization for pets in your rental agreement, if adoption is approved? *(Required) Yes No Own/Not applicable 26. If applicable, please provide your landlord's name and phone number. 27. How will you keep your dog confined when outdoors? *(Required) Fence Kennel Run Patio Garage Chain/Tie-out/Runner Other Other(Required) 28. Please specify the type and height of your fence. If you do not have a fenced-in yard, please enter "No Fence" *(Required) 29. Where will the dog spend most of their time? *(Required) Inside Inside with dog door access Outside Garage Other, Explain Other, Explain(Required) 30. Will you let the dog run off-leash in any unfenced areas? *(Required) Yes No 30. Explain(Required) 31. During a typical day, how many hours do you expect the dog to be left alone?(Required)Select1-34-67-910 or more32. How will you keep the dog confined while you are gone to work or on errands, etc? *(Required)33. Where will the dog sleep at night? *(Required)34. Do you plan on attending training classes? *(Required) Yes No 35. What is the name of the dog's primary care giver? *(Required) 36. Briefly describe your knowledge of heartworm disease; how it is transmitted and how it can be prevented: *(Required)37. Have you ever had a dog diagnosed with and/or treated for heartworms? *(Required) Yes No 37. Explain(Required) 38. If you currently have a dog, please provide the name of the heartworm & flea preventative they are taking. If no pets, enter NA *(Required)39. Please provide name and phone number of your current/previous veterinary clinic. If no current or previous pets, enter “NA”.(Required)40. Please provide the pet owner's name under which your pet's vet records are kept?(Required) 41. Do you authorize the veterinarian listed above to release to HBHR information pertinent to evaluating your history of pet ownership? *(Required) Yes No Not Applicable, never had a pet 42. To provide food, medical care, registration and grooming for this dog, how much do you anticipate spending yearly?(Required)$400$600$800 or more43. Are there other pets in the home? *(Required) Yes No 44 Please list the name of each of your pets, species/breed, gender, age, and how long you have had them. If no pets, enter “no pets”.(Required)45. If you have pets, are all spayed or neutered? *(Required) Yes No Not Applicable, no pets 46. Please list all previously owned pets, including species/breed, how long you had them, and why you no longer have them. If no pets, enter “no pets”. *(Required)47. If your new dog isn't getting along with your existing pets or children, what would you do? *(Required)48. If the new dog is not getting along with your existing pets or children, how long are you willing to give them a chance to get along? *(Required)49. If you suddenly relocated or had other drastic lifestyle changes that made it hard to keep your pet, what would you do with your pet? *(Required)50. Personal Reference: Include name, phone number, email address and their relationship to you. *(Required)51. If you have any additional information you would like to provide to us please do so here:52. In which of our dogs are you most interested? *(Required) 53. Which of our dogs would you next be willing to consider in case your first choice is unavailable for adoption? 54. Are you willing to submit to an adoption interview and home visit? *(Required) Yes No 55. Do you agree if approved for adoption, to sign our Adoption Agreement and to pay the adoption fee (see adoption fee info on HBHR website) upon receipt of the beagle? *(Required) Yes No 56. How did you become aware of HBHR?(Required) Search engine HBHR Website Previous Adopter Adopt-a-Pet Petfinder.com Friend Other Other By submitting this application you certify that the above information is true. HBHR reserves the right to deny any application based on false information or any responses that cause concern for the welfare and safety of the beagle. All submitted applications become the property of HBHR and will be retained in its files.Please click the Submit button only ONCE to avoid duplication of your completed form. You will receive a confirmation email when it has submitted successful.CAPTCHA Δ
