If you are interested in a Silvan basset hound, please take a moment to tell us a little about yourself and why you're interested in a basset hound. Your responses to the questions below will determine if you and your family will be a good fit for one of our puppies/adult bassets.

* Full Name:

* Address:

* City, State & Zip

* Telephone:

* Email Address:

Best Way To Contact Me Is:

Phone

Email

How Did You Find Us?:

Online Search

Personal Referral (who)

* Number of Children In the Home?:

* Do You Rent or Own?:

Rent

Own

* Do You Have a Fenced Yard ?:

Yes

No

* Are There Other Pets in the Home?:

Yes

No

* Have You Ever Owned a Basset Before?:

Yes

No

* What Sex Do You Prefer?:

Male

Female

Any

* What Color Would You Like?:

Red & White

Tri-Color (Black, Brown & White)

Any

* Silvan Bassets places all puppies/Adults with a legally binding purchase contract which will provide you with certain rights and health guarantees and provides us with certain assurances that the dog will be properly cared for. Would you be willing to sign such a document?

Yes

No

* Silvan Bassets' pet puppies are placed with a spay/neuter contract and on limited AKC registration. Do you understand what "Limited AKC Registration" means?:

Yes

No

* This Puppy/Adult Will Be:

Strictly an Outside Dog

Strictly an Indoor Dog

Combination Indoor/Outdoor

* This Puppy/Adult Will Be Used for:

Show

Breeding

Pet Only

Therapy Dog

If this Puppy/Adult is going to be used for any purpose other than a family pet please provide at least 2 personal references (fellow breeder, vet, or mentor).

* Tell Us About Yourself-Why Do You Want a Basset Hound? Include info. on additional pets if you have others:

* Indicates Response Required