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North Bay Beagles Adoption Application

Contact Information
Name of Dog*
Name*
First Last
Occupation
Address
How Long at this address
Daytime Phone
Evening Phone
Best Time to Call

: HH

MM
Email Address*
Family & Housing
How many adults are there in your family (their relationship to you)?
How many children (ages)?
What type of home do you live in single family, town home, apartment, farm, etc.?
Please describe your household
If you rent, please give the rules governing pets and the landlord’s name and number:
By providing this information you are allowing NBBeagles to contact your landlord. Please inform them of this call so they will speak with us
Does anyone in the family have a known allergy to dogs?
Is everyone in agreement with the decision to adopt a dog?
Do you have time to provide adequate love and attention?
What other pets do you have (specify type and number)?
Are these pets up to date on vaccines?
Are these pets spayed/neutered? If not.why?
Have you every surrendered a pet? If so, why?
Have you ever had a pet euthanized? If so, why?
Have you ever lost a pet to an accident?
How do you discipline your pets and why?
Do you have a regular veterinarian?
- Yes
- No
Veterinarian’s name:
First Last
Clinic Name:
Clinic Address:
Clinic Phone:
(Providing NBBeagles with this information you are allowing NBBeagles to call your vet. Please call your vet and ask them to authorize the release of information to NBBeagles.)
About the Dog You Wish to Adopt
Where will the dog spend the day? (describe)
Where will the dog spend the night? (describe)
Number of hours (average) dog will spend alone?
Who will have primary responsibility for this dog's daily care?
Who will have financial responsibility for this dog?
Do you agree to provide regular health care by a Licensed Veterinarian?
- Yes
- No
Do you agree to keep the dog as an indoor dog?
- Yes
- No
When the dog goes out, how do you plan to supervise it? Fenced yard?
Do you agree to contact NBBeagles if you can no longer keep this dog?
- Yes
- No
Are you be willing to let a representative of NBBeagles visit your home by appointment?
- Yes
- No
How did you hear about NBBeagles?
Would you be interested in fostering?
- Yes
- No
- Would like to know more
Personal Reference: By providing this information you are permitting us to call your reference.
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Relationship (relative, neighbor, friend, etc.):
All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian. By submitting this form you are agreeing to the above.
Date
Date Format: MM slash DD slash YYYY
Please type name

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Contact Us

Phone:
(707) 360-7539
Mailing Address:
2777 Yulupa Ave #285
Santa Rosa, CA 95405-8584
Email:
pam@nbbeagles.com

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Phone: (707) 360-7539 501(c)(3) Tax ID: 47-2707806