First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

Email*

Home Phone

Cell Phone*

Alt Email

Occupation*

How did you hear about us*

Do you currently own (or have you previously owned) a Beagle?*

If yes: Where did you get your beagle?

Why did you choose the beagle breed?

Your dog is/was primarily a

If you no longer own your beagle, what happened

Are you familiar with the characteristics of the beagle breed? (barking nature, tendency to run off, etc.)*

What kinds of experience do you have working with dogs from shelters or in rescue)? *

Are you familiar with the problems faced by new owners of rescued dogs? (readjustment periods, housebreaking relapses, separation anxiety, etc.)*

What else can you tell us about your other experiences working with animals

As an all-volunteer organization, we need help with a variety of things. Please indicate which things you would be willing to help with

Days / Times you are available to volunteer*

Who will be the primary caretaker of the dog*

Does anyone in your family have allergies*
Choose one: Yes No

If yes, to what?

How many adults in home*

Does everyone work?*
Choose one: Yes No

How much time will the animal spend alone during the day*

Where will the animal be kept when you are not home*

How many children in the home*

Children's names and ages

Do you own or rent your home*
Choose one: Rent Own

How long have you lived at your current residence?*

If you rent, please enter your landlord's name and phone number

If you rent, have you received the approval of your landlord to have an animal
Choose one: Yes No

Is your yard fenced*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What is the height of the fence (if applicable)

What type of fence (if applicable)
Choose one: Privacy Chain Link Invisible

We would like to know about your current/previous pets, including their name, type of animal, if you still have them (and if not, what happened to them) and how long ago you had them

Veterinarian's Name and Phone Number:

List two references (who are not family members) including name and telephone number.*

I authorize the veterinarians listed above to supply information to The Tampa Bay Beagle Rescue, in regards to my pets above.

I certify that the above information is correct, and I give permission to contact the references I have given. I certify that I am 18 years of age or older.

Please enter your name and the date as your legal signature.*