*= Please note that these fields must be completed

INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED!!

Personal Information

* Name (First and Last): Spouse/Live-in Partner's Name: * Street Address: City: State: Zip Code: * Home Phone: Cell Phone: * Email: Occupation: Work Phone: Can we contact you at work? Yes No Hours you are at work Days you are at work

Adoption Information

* Have you read and understand the CBR-West Adoption page?  By indicating "yes," you acknowledge that a home visit may be required, and will allow a CBR-East volunteer to complete this.  You also acknowledge that there is an adoption fee ranging from $200-$350, and that CBR-West reserves the right to deny any application.   Yes No Where did you hear about CBR-E? (select all that apply) Internet Search/Web Petfinder Word of Mouth/Friend Sign or Poster Newspaper Article Rescue Which rescue? Shelter Which shelter?   Other (please explain) Why did you choose to adopt a beagle?: For what will the beagle be used? (select all that apply) Pet/Companion Hunting Breeding Companion for children Guard-dog/protection Other Have you had beagles before? Yes No   This dog will primarily be in: House Outside Where will the dog be left while you're away from home? Run of house Crate Garage Yard Doghouse   Other (please explain) What is the longest period of time the dog will be left alone?   How many children in the home?   How many adults in the home?     Child #1: Child #2: Child #3: Child #4: Child #5: Ages of children in the home: Do all of the adults work? Yes No   Is anyone home during your work hours? Yes No If you responded "yes" please tell us who is home during the day:   In what type of dwelling do you live? Single Family Home Townhouse Apartment/Condo Mobile Home Duplex   Do you own or rent? Own Rent If you rent, does your lease allow pets? Yes No   How long have you lived there?   Landlord's Name: Landlord's Phone: Is your yard fenced? Yes No Is it suitable for a dog (i.e., fenced on all sides)? Yes No How tall is the fence?   What material (chain-link, wood), is the fence made of? Are you willing to install a fence if you do not currently have one? Yes No If no fenced area is available, how will you handle exercise and toilet duties?    Will the beagle be walked?  Yes  No If yes, how often?   Will the beagle be exercised in a fenced in yard? Yes  No If yes, how often?   Will the beagle be allowed to run free of restraint in an unsecured area (i.e., roam the neighborhood, spend time in an unfenced yard, etc.)? Yes  No Are you aware of the dangers of leaving your beagle outside in an enclosure when you are not home? (i.e., beagle could dig under or climb over fence, become a nuisance barker to neighbors, or even be stolen) Yes No Are you aware that beagles are quite vocal and can bay loudly at times? Yes No Are you aware that beagles cannot be let off leash because they will run off? Yes No *Are you aware that beagles can take up to 30 days to adjust to a new environment and that this adjustment period may result in a lack of enthusiasm for play or other activities, etc? Yes No Are you planning to move or take a vacation within the next 2 months? IF YOU ANSWERED "YES," PLEASE NOTE THAT THIS MAY NOT BE THE BEST TIME TO ADOPT A BEAGLE!  Our rescue Beagles need stability in the first few months in a new home.  Please consider pending your application until a later date. Yes No Who will care for your beagle when you are away from home for more than a day?   If you move, what will you do with your beagle?   Are you prepared to take on the financial obligation of adopting a dog - food, licensing, routine vaccinations, heartworm prevention, flea and tick preventative, and unforeseen medical needs? Yes No Which member of your household will be the primary caregiver for training, feeding and general care? Are you willing to housetrain a dog if necessary? Yes No Are you planning on taking your dog to a basic obedience class? Yes No How do/would you discipline your beagle? Do you realize that at some point your beagle will inevitably destroy something of yours? Yes No Is anyone in the home allergic to animals or have asthma? Yes No If yes, please explain how this will be handled:   Have you applied to adopt with any other rescue organization? Yes No

Current Pet Information

Pet's Name Type Age Sex/Altered? Pet #1 Pet #2 Pet #3 Other: Where are your pets left while you're away from home? Run of house Crate Garage Yard Doghouse   Other (please explain) Are your pets allowed on the furniture or bed? Yes  No Vet's Name: Vet's Phone Number: (A vet reference MUST be provided for previous and current pets.) *By checking here, I hereby authorize the veterinarian listed above to supply information to Cascade Beagle Rescue with regard to the pets listed on this form. Please provide a personal reference (No family members or people residing in the same home.) * Reference Name: * Reference Phone Number:

Previous Pet Information

Pet's Name: Type: What happened? Be specific: How long ago?: Pet #1 Pet #2 Pet #3 Have you ever put an animal up for adoption?: Yes No   If yes, what was the reason?:

Beagle Information

Do you prefer a male or female beagle, or no preference? Male Female No preference Why? What age beagle do you prefer? (select all that apply) No Preference Puppy Young (1-3 years) Adult (3-5 years) Older adult (5-8 years) Senior (8 and older) What energy level do you want in a beagle? (select all that apply) High Energy Couch Potato In the middle No preference Will you consider a special needs dog such as one who requires medication for a permanent, but controlled condition (i.e., epilepsy, hypothyroidism)? Yes No  Will you consider an inseparable PAIR of beagles? Yes No  Will your beagle be allowed on the furniture or bed? Yes No Please describe your ideal match:   * We expect you to commit to caring for this beagle for the remainder of its life. If you can not keep the beagle for any reason, you MUST return it to CBR-West. You may not give it to a family member or a friend. Are you willing to agree to this and be legally bound by signing the CBR-West adoption contract upon adopting a beagle? Yes No  DISCLAIMER: I understand that completing this application is not a guarantee that I will be approved to adopt a beagle and the Cascade Beagle Rescue has the right and responsibility to deny any application.  By submitting this form, I agree that all the above information I have provided on this application is, to the best of my knowledge, true, and complete and permission is granted to Cascade Beagle Rescue to call any references I have included on my application. I also grant permission to Cascade Beagle Rescue to obtain up to date records from the vet reference I have specified on this application. I understand that falsifying answers on this application, or at any other time during the adoption process, disqualifies me from adoption. Additionally, I acknowledge that Cascade Beagle Rescue does not guarantee the health or temperament of any beagle that may be placed; however, every effort is made to provide accurate and detailed information about all beagles in our program.  It is the responsibility of the adopter to provide adequate health screening and training.     Please email us with your comments, questions or suggestions. Cascade Beagle Rescue would like to thank B.O.N.E.S (Beagles of New England States) for permission to use and modify their online adoption form.