Applicant First Name *
Applicant Last Name *
Co-Applicant First Name
Co-Applicant Last Name
Street Address *
Home Phone *
How did you learn about BROOD? Previous BROOD Adopter or Foster I am a BROOD Member Facebook Internet Search BROOD Website Newspaper Attended BROOD Event Saw BROOD at an Event Friend, Relative or Neighbor Animal Shelter/Other Rescue Group
Why are you interested in fostering?
A successful adoption depends on both the selection of the right basset for the "adopter's" household and the understanding of his caretaking needs that the "foster" provides us. As the foster, your role is to assess the adoptability and behavioral characteristics of the dog while it is in a normal family environment. 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
Name of Vet or Vet Clinic/Hospital
Vet Street Address
Federated States of Micronesia
U.S. Virgin Islands
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? *
-select- House Apartment Townhome Condo Trailer Farm
Do you have a fenced area or yard for the dog? * Yes No
If yes, what kind of fence?
If you dont have a fenced yard, how do you plan to exercise your foster dog?
Have you ever taken a basic dog obedience course? * Yes No
Please rate yourself on your ability/experience with training dogs, including
housetraining, basic manners like sit and come when called, and on retraining for dogs with problem behaviors such as chronic barking or chewing.
(pick the choice below that most closely matches your experience level) * I do not have a lot of experience, but am willing to attend training classes to learn more. (no experience) I have experience training my own dog(s) to be housebroken and with basic commands, but have not attended obedience classes OR
I have attended only a puppy socialization class. (a little experience) I have housetrained multiple dogs and attended obedience classes, and feel comfortable with housetraining and
providing basic manners training to a new dog. (experienced) In addition to the statement above, I have successfully worked with a dog with a serious or chronic behavior problem
such as separation anxiety, chronic barking, fearfulness or aggression. (advanced experience)
Please provide details of your experience with training dogs
Have you ever had a dog with a behavior problem? * Yes No
If yes, please provide details and what actions you took to correct it.
Have you ever had a dog with a health problem? * Yes No
If yes, please provide details.
Have you ever adopted a dog? * Yes No
If yes, from where? (check all that apply): City/County Shelter SPCA Humane Society Rescue Group Private Shelter Other
Have you ever fostered a dog? * Yes No
If yes, for whom? (check all that apply) * City/County Shelter SPCA Humane Society Rescue Group Private Shelter Other Not Applicable
Are you currently fostering any dogs? * Yes No
IF NECESSARY ARE YOU WILLING TO ...
House train your foster dog? * Yes No
Work with a behavior problem? * Yes No
Work with a health problem? Yes No
Crate train your foster dog? * Yes No
DO YOU UNDERSTAND THAT YOU MAY BE REQUIRED TO ...
Take your foster for routine and emergency veterinary care, including dental work? * Yes No
Take your foster to training? * Yes No
Meet with prospective adopters? * Yes No
Transport your foster dog to adoptathons? * Yes No
Attend foster training? * Yes No
DO YOU UNDERSTAND THAT ...
You will have to sign a Foster Agreement? * Yes No
You will be responsible for providing food and shelter for your foster? * Yes No
BROOD will reimburse any veterinary care required for your foster? * Yes No
BROOD requires routine Foster Reports? * Yes No
The foster is not YOUR dog, but a BROOD dog? * Yes No
As a foster parent, you will be expected to relinquish the dog to a qualified adopter? * Yes No
Please use this space to provide any additional information you feel is pertinent.
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 process, disqualifies me from fostering.
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 Entries