| |
* If you are interested in fostering a particular dog, please list his/her name below: |
|
|
|
Personal Information |
* Name |
|
| * Address |
|
| City |
|
| State |
|
| Zip |
|
| Phone - Work |
|
| * Phone - Home |
|
| * Driver's License # |
|
| * Email |
|
|
What is your Pet Experience |
| Is this your first foster dog? |
Yes
No |
If yes, how have you prepared your home and family (chewing, exercise,
housebreaking, training)? |
|
|
Do all your family members support this? |
|
Yes
No |
How much do you know about the breed/mix that you want to foster? |
|
|
|
Home, Family & Living Circumstances |
Number of Adults and Children living in your household and ages. |
| Adults & Ages -
|
| Children & Ages -
|
Does anyone in your household have allergies? If yes, please
explain. |
|
|
Do you have a fenced yard?
Yes
No |
If yes, what type of fence, i.e how tall, wood or chain? If no,
how will your dog be restrained when outdoors? |
|
|
Do you...? (check all that apply) |
| Own
Home/Condo |
Rent Home/Condo |
|
Rent Apartment |
Live in Mobile Home Park |
|
Live with someone else |
If Renting, Landlord's name and phone number... |
|
|
Do you live where there are restrictions against fostering dogs?
Yes
No |
|
Pet Information - Current & Past |
How many animals do you have now?
|
How many dogs? |
| Dogs' names (if applicable)
|
| Sex of dogs?
|
| How many cats?
|
| Cats' names (if applicable)
|
| Sex of cats?
|
Are your pets all spayed or neutered?
Yes
No |
If your pets are not spayed/neutered, please explain why they are not. |
|
|
Have any of your pets run away? |
|
Have any of your pets been hit by a car or killed on the road? |
|
|
Have you ever had to put an animal to sleep? If yes, please
explain. |
|
|
Have you ever given a pet away? If yes, please explain. |
|
|
Where will the dog spend most of it's time? |
|
In the house |
|
Outside |
|
Other, Please explain
|
What would you do if you could no longer foster this dog? |
|
|
Under what conditions could you no longer foster this dog? (Check all that
apply) |
|
Soils in
house |
Barks
too much |
|
Chews |
Unruly behavior |
|
Allergies
in family |
Bites someone |
|
Other, Please explain
|
If your foster dog has housebreaking problems, what will you do to make it work? |
|
Crate |
Leave Outside |
|
Bring Back Too Us |
Other |
| Explain Other - |
|
|
If you have to go away for several days or longer, who will care for your dog? |
|
|
|
Vet Information |
Do you take your pets to a Veterinarian for annual checkups?
Yes
No |
| * Who is your Vet? |
|
| Vet's Address |
|
* Vet's Phone Number
(we must have a phone number to verify) |
|
|
Signature & Date |
|
* Would you allow a Rescue Representative to visit your home regarding this fostering commitment? |
|
Yes
No |
|
|
* Signature
* Date |
|
