NO REFUNDS & NO PERSONAL CHECKS

If a Basset/Pug is being abused, neglected, not getting proper medications or vet care and/or if it is not inside it must be kept on leash with owner it cannot be left loose or unattended. If outside; dog must be in a fenced area at all times or on leash. Any violations will result in the Basset/Pug being picked up and returned to Basset/Pug Lovers Rescue with no return of adoption fees and with no liability for medical bills or any other expenses you may have incurred.

This information will be printed right on your signed application. This is a legal, binding document and will be used in a court of law if necessary (at your expense). By signing this contract, you signify that you agree to ALL the terms therein.


Thank you for your interest in adopting a Basset Hound or Pug. We would appreciate your answers to the following questions so that we can best select the right dog for you. All information is confidential. ***   In the event that your new dog does not work out for you and your family, the dog must be returned to the Bassets/Pug Lovers Rescue. Filling out an application does not guarantee a basset to anyone. We have the right to refuse any application without an explanation. Filling out and sending in this form signifies that the above information is correct and you have read and agree with our rules.   *** Please complete the application thoroughly. Print out and fill out or copy & paste and snail/email it to us at

Basset/Pug Lovers Rescue
PO Box 66
York, SC   29745
NO REFUNDS & NO PERSONAL CHECKS

Name:_______________________________________________ Date: ___/___/___

Address:________________________________________________________________

City:______________________________ State:__________ Zip Code:_________

Home Phone: (____)__________________ Work Phone: (____)___________________

Email Address:_____________________________ Cell Phone: (____)______________

Where did you hear about Bassets/Pug Lovers Rescue?__________________________________________________________________________________________________

Do you: own a home own an apartment/condo/town home rent

If you rent, does your landlord allow pets? yes no

Please list the name & phone number of your landlord:___________________________________________________

Number of adults living in your household (including you):_______

Number of children living in your household:_______ Ages?:__________________

Your dog will be kept primarily: inside outside

If outside, does your yard have a fence? yes no

Will your dog be left alone during the day? yes no If yes, for how long?_______

What is your motivation for getting a pet at this time?______________________________________________________________

______________________________________________________________________

Do you have other pets in your home? yes no

If yes, what types of animals and how long have you owned them?_________________________________________________________________

______________________________________________________________________

_____________________________________ (use separate sheet if necessary)

What veterinarian/clinic do you use or plan to use? Please include veterinarian/clinic name along with address and phone number.______________________________________________________________

_____________________________________________________________________

Would you consider adopting a special needs dog/puppy (ie. Blind, timid, 3 legged) yes no

Would you still be able to care for this dog if your home or family situation changed (divorce, relocation)? yes no

Which would you prefer? puppy adult senior

Which would you prefer? female male

Is there a specific dog on the website that caught your eye?_________________________

Is there any other pertinent information you would like to share?____________________________________________________________

__________________________________________________________________

__________________________________________________________

In the event that your new dog does not work out for you and your family, the dog must either be returned to the Bassets/Pug Lovers Rescue, or a new home must be approved.

By signing below, you certify the information provided above is correct, and that you agree to and will abide by ALL of our terms.

Signature ________________________________ Date ___________