BROOD Application to Adopt

Please complete this form and submit it ONLINE regardless of how you intend to pay the application fee. After you complete this form you can submit your application fee for $10 (Check, Money Order or Paypal). If paying by Check, print out the form using the "Print" button at the bottom of this form before you submit it and mail it with your check.

BROOD adopts dogs to residents of Maryland, West Virginia, DC, Delaware, most of Virginia and parts of Pennsylvania ONLY. We do not serve North Carolina, Tennessee, Ohio or Kentucky. If you live in the TIDEWATER area of Virginia (near Norfolk) please contact Basset C.A.R.E. instead. You must be 21 years old or older to apply.

If you have any questions, please contact our BEFORE you submit your application.
Applicant First Name *
Applicant Last Name *
Co-Applicant First Name
Co-Applicant Last Name
Street Address *
City *
State *
Zip *
Home Phone *
Work Phone
E-mail Address: *
How did you learn about BROOD?

A successful adoption depends on both the selection of the right basset for your household and the understanding of his/her care-taking needs. So that we may assist you with this selection, please answer the following questions as completely as possible.
How many people are there in your household? *
Ages of minor children?
Approximately how long would the dog be left alone within a 24-hr period? *
Are you established with a veterinarian? * Yes
No
- If yes, Name of Vet or Vet Clinic/Hospital
- Street Address
- City
- State
- Zip
- Phone
- Fax
Have you ever owned a dog? * Yes
No
Have you ever owned a basset hound? * Yes
No
- If yes, what happened to the dog, or any other dogs you have owned.
Do you have any other pets (birds, cats, etc) in the household? * Yes
No
- If yes, please list.
Your home is currently * Owned
Rented

IMPORTANT: If you rent you MUST have proof of your legal ability to keep a dog (i.e., a copy of your lease, written letter from the landlord, tenants association or rental office, etc.) available for inspection when your home visit is performed.
What most closely describes your type of home? *
Do you have a fenced area or yard for the dog? * Yes
No
- If yes, what kind of fence?
- Are you willing to reinforce/repair your fence, if needed? Yes
No
If you dont have a fenced yard, how do you plan to exercise your pet?
Do you have neighbors who would be bothered by a barking dog? * Yes
No
Have you ever taken a basic dog obedience course? * Yes
No
Have you ever adopted a dog? * Yes
No
If yes, from where? (check all that apply) City/County Shelter
SPCA
Humane Society
BROOD
Another Rescue Group
Private Shelter
Other
- If you adopted from BROOD, when? (approximate date is ok)
- What was the dogs name when with BROOD?
- Have you moved since you adopted from BROOD? Yes
No

ARE YOU WILLING TO ....

- Take your new basset to the vet for a physical within 10 days of adoption? *

 Yes
No
- House train your basset? * Yes
No
- Take your basset to obedience school? * Yes
No
- Purchase a crate and crate train your basset? * Yes
No

ARE YOU AWARE THAT BASSETS ...

- Need to be checked annually for heartworm and put on heartworm preventative? *

 Yes
No
- Require routine and emergency veterinary care, including dental work? * Yes
No
- Need periodic grooming, to include brushing coat, trimming nails, and ear cleaning? * Yes
No
- Need plenty of exercise? * Yes
No
- Young puppies (under 6 months) are rare and popular in rescue. If you want a puppy are you willing to be placed on a waiting list? * Yes
No
Not interested in puppy
- Are companion dogs and are to live inside your home and be an active part of the family? * Yes
No
- Are scent hounds and therefore must never be off leash in an unsecured area? * Yes
No
Are you aware that the average cost in the first year to outfit your dog (leash, collar, dog bed, bowls, food and vet care) could exceed $1000? * Yes
No
Will you allow a volunteer to visit your house and meet with your entire family? * Yes
No
You will pay an adoption fee and be required to sign a legal Adoption Contract? * Yes
No
What gender of dog are you looking for? * Male
Female
No Preference
What age of dog would you prefer? *
Under what circumstances would you give up your dog? (please check ALL that apply) We need to relocate
We have a baby
The dog requires expensive veterinary care
Someone in the family becomes allergic
Someone in the family becomes very ill
There is a divorce in the family
Dogs main caretaker leaves (for college, another job, called up for overseas duty, etc.)
Dog does not get along with other pets
Dog becomes incontinent or forgets housetraining
Dog has separation anxiety
Dog becomes aggressive towards a family member
Other (please describe below)
Other reason(s) for giving up a dog

We ask these questions so that you will think about all of the aspects of bringing a dog into your family. Your response does not automatically cause you to be disqualified from adoption.
Do you have a close friend or family member who would be willing to provide long-term care for your dog if an emergency arose? * Yes
No
Please use this space to provide any additional information you feel is pertinent.
How do you plan to pay the $10 application fee? * Check
PayPal
Verification Code:
Enter Verification Code: *

All the information I have provided on this application is, to the best of my knowledge, true and complete. I understand that falsifying information on this application, or at any other time during the adoption process, disqualifies me from adoption. I am aware that submitting my application does not guarantee that I will receive approval to adopt a dog from BROOD and that BROOD reserves the right to reject any applicant at any time during the adoption process. I also understand that the $10 application fee is non-refundable.

With the electronic submission of this application form, I am authorizing BROOD to contact my veterinarian to discuss my veterinary records.

AS REQUIRED BY THE CODE OF VIRGINIA, CHAPTER 787 3.1-796.96.C.3, I/WE ALSO CERTIFY THAT I/WE HAVE NEVER BEEN CONVICTED OF ANIMAL CRUELTY, NEGLECT OR ABANDONMENT.

     
* Required Responses