Name(s) of Applicant(s): Address: City: State: Zip: Home Phone: Work Phone: Fax: Email address: Children at home: Yes No Ages: Have you lived with a basset before? Yes No For how long? What happened to the dog(s)?  What qualities are you looking for in a companion pet?  Describe what you know about Basset Hounds and their health/behavior     I am willing to foster a: No Preference Male    Female     I am willing to housetrain a dog. Yes    No                               Rescued Bassets often have housetraining problems when adjusting to their new homes. How would you deal/handle this?     Do you have children in your home? Yes   No If so, what are their ages? Do all members of the family want to foster a basset hound? Yes No    If not, please explain: I live in a House Condo         Apartment Mobile Home    Is the house: one story or two story?  1 Story   2 Story   Other  If you live in a two story house, how do you plan to keep the Basset downstairs to preserve its back/spine? If Condo or Apartment Upstairs Downstairs Is property completely fenced? Yes No              Partially Do you have a doggy door? Yes  No    Where will the dog be kept during the day?   Where will the dog sleep at night?   Have you had an opportunity to research Basset Hounds? Yes No  Where did you learn about BHRSC?   Any other pertinent information?

By sending this form to the Basset Hound Rescue of Southern California I agree that: