Form

Tall Tails Beagle Rescue - Application
Applicant Name*
First Name Last Name
Co-Applicant Name
First Name Last Name

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone*
- Area Code Phone Number
Cell Number
- Area Code Phone Number
E-mail*
Occupation:
Would you like to foster or adopt a dog?*

Adopt a dog Foster a dog
Is there a specific dog that interests you?*
Why are you interested in a Beagle?*
What energy level are you looking for in your new dog?*

High Energy Medium Energy Low Energy Couch Potato
Have you ever owned a Beagle before?*
This Beagle will mainly be:*

a house dog an outdoor dog
Does anyone in your household have allergies? If "yes" please list/describe:*
Is anyone in your home afraid of dogs?*
How many adults live in the home?*
Do all of the adults in the home work?*
How many hours per day will the Beagle be left alone?*
Where will the Beagle be left when alone (i.e., in the home, crate, in the yard, garage?)*
Where will the Beagle sleep at night (i.e., on a dog bed, in a crate, in the garage, in a dog house?)*
Do you have children that live in or visit the home?*

Yes No
If so, please list the names and ages of children :
Housing
Where do you live?

House Apartment Condo
How long have you lived at this residence?
Do you own or rent?*

Own Rent
If you rent, does your lease allow pets?

Yes No
If you rent, please provide the name & phone number of your landlord:
Does your residence have a fenced in yard?*

Yes No
If your yard is fenced in, please describe the fencing (fence material, height, size)
If you do not have a fenced yard, please describe how you will contain your dog while outside:
How will you exercise your rescue dog?*
Current Pets
Do you have any other pets?*

Yes No
If yes, are all pets spayed/neutered and up-to-date on vaccines?
If yes, please list all current pets in the home (name, breed, sex, age):
Previous Pets
Have you ever given up a dog?*

Yes No
Describe previous pets you have owned, how long have they lived and ultimately, what happened to them*
Veterinary Care
Are you prepared financially to provide proper medical and personal care for a Beagle at this time? (About $500.00 per year?)*

Yes No
Have previous dogs received monthly flea/tick & heartworm prevention?*

Yes No Not applicable - never owned a dog
What brands of flea/tick and heartworm prevention will you use for your new dog?*
Please provide name and contact information for your current and past veterinarians:*
I give my permission for the veterinarian(s) above to supply information to Tall Tails Beagle Rescue with regard to my pets*

Yes No Not applicable - no vet
Please list two personal references below (no relatives please.)
Personal Reference #1*
First Name Last Name
Phone Number*
- Area Code Phone Number
Personal Reference #2*
First Name Last Name
Phone Number*
- Area Code Phone Number
Please use this space to give us any additional information that you would like us to consider in the adoption process
I confirm that the above information is correct and I give my permission to contact the references that are listed.*
Applicant's Full Name
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Tall Tails Beagle Rescue - Application

Housing

Current Pets

Previous Pets

Veterinary Care

Please list two personal references below (no relatives please.)