Name*
Address*
Home Phone*
Work Phone
Mobile*
Email Address*
Drivers License Number
How did you hear about Beagle Rescue Victoria?
1. What beagle are you applying for? (leave blank if you have no preference)
Beagles name:
2. What is your preference?*
3. What age would you prefer?*
4. How many Beagles would you like to adopt?*
5. Have you read the page entitled "Is a Beagle For Me?" on our website?*
6. Are you employed?*
7. How many adults live in your household?*
8. How many children live with you?*
9. What are their ages?
10. How many hours a day will your Beagle be on its own?*
11. Do you have other pets*
If yes, please specify type, breed, sex and whether or not they have been desexed.
12. Would you consider adopting a beagle who has sustained an injury or who suffers
from an existing illness or disability? (Can you afford to look after an ill or disabled beagle?
Could you deal with the heartbreak if the beagle did not live long?) *
13. Would you consider a cross-breed beagle?*
14. Previously, have you ever owned a beagle?*
If yes, please tell us about your existing beagle and its temperament
If no, what is your knowledge of the breed?
If no, please tell us what behaviours and qualities you are looking
for in your new beagle?
15. If you are a previous dog owner (any breed), how long did you own this dog?
16. Where is your dog now?
17. If your dog was re-homed or surrendered, please explain the
circumstances of the re-homing/surrender.
18. In your opinion, which of the following circumstances justifies surrendering a pet?
Tick as many as you think applicable.
Moving House Personality clash with other pets
Escaping from your yard Too time consuming
Financial Problems Children have lost interest
      and no longer take responsibility
Excessive Barking Ongoing medical problems
Toilet training problems Coat shedding
Destructive behaviour Fears for safety of new baby
Fear of pet becoming lonely
     while you're away from home		 Divorce/Relationship break up
Other - please specify
19. Which best describes your home?*
20. Do you:*
If renting, you will need to attach to your application approval from your landlord that you may own a dog.
NOTE: Only PDFs, JPGs and Word Documents are accepted. Files must be under 2MB.
21. What type of fencing do you have?*
Suburban Paling
     Fence		 Colorbond Fence Farm Fencing Other
Other - please specify
21b. How tall are your fences?*
21c. Are you prepared to make adjustments to your fencing to ensure it is beagle proof?*
22. What is the approximate size of the secured fenced area where your beagle will have access?*
23. Do you have a doggie-door?*
24. Is your motor vehicle air-conditioned?*
25. Do you have a pool?*
26. If yes, is it beagle-proof?
27. Where do you envisage your beagle sleeping?*
28. Are you aware that beagles cannot be let off leash because they will run away?*
29. Are you aware that beagles are best suited to a multi dog house hold?*
30. Are you aware that beagles are vocal at times and can bay loudly?*
31. Are you aware that beagles can take up to 30 days to adjust to a new environment?*
32. Do you pledge to allow your beagle indoors?*
33. Do you pledge to have your beagle vaccinated, wormed and heart-wormed at the
required intervals?*
34. Do you pledge to purchase products which will keep your beagle flea-free?*
35. Do you pledge to seek veterinary treatment when required?*
36. Do you pledge to return your beagle to us if you encounter any difficulty?*
37. Do you pledge to love and care for your beagle and consider his/her
needs to be of supreme importance?*
38. Would you agree to allow BRV to visit you at your home prior to adoption?*
39. Would you object to an occasional phone call or email from BRV enquiring
about your beagle’s well-being?*
40. Is there anything else BRV should know in accessing your application?
41. Please provide the details of your regular vet clinic:
Name*
Address*
Phone*
42. Please provide the names and contact phone numbers of two personal referees:
A*
B*
I agree that the information contained within this form is true and correct at the time of this application.
Name*
Date*