First Name (required)

Last Name (required)

Address (required)

City (required)

State (required)

Zip Code (required)

Home Phone

Cell Phone (required)

Email Address (required)

List all members of house and ages for all minors:

Employment Status (required)
Full TimePart timeRetiredNot employedStay at home parentStudent

Please describe in detail your work schedule(s)? (required)

Are you willing to attend safety training? (required)
YesNo

Will you agree to a home visit? (required)
YesNo

Do you Own or Rent? (required)
OwnRent

(Renters Only) Do you have permission from your landlord to foster a dog?
YesNo

Name of Landlord

First Name (required)

Last Name (required)

Phone of Landlord (required)

Do you have homeowners/renters insurance? (required)
YesNo

Name of insurance company:

Do you have medical insurance for all members of your household?(required)
YesNo

Name of insurance company:

Which best describes your household? (required)
QuietActiveVery Active

Where will the foster dog be kept during the day? (required)

Where will the foster dog be kept during the night? (required)

Will you crate the dog? (required)
YesNo

Is your yard fenced? (required)
YesNo

Fence Height (ft.)

If not fenced in, how will you exercise the dog?

Have you ever attended Obedience Training Classes? (required)
YesNo

If yes, where did you attend classes and for how long?

Have you ever had a dog before? (required)
YesNo

How many?

Size of Dog(s):
SmallMediumLarge

Have you ever had a dog with behavioral problems? (required)
YesNo

If so, how did you address them?

If you have children, have they had dogs?
YesNo

Are your children afraid of dogs?
---YesNo

Are they or any member of your household allergic? (required)
YesNo

Describe any experience handling dogs:

Please provide a description of how you would correct your foster dog if it showed destructive or inappropriate behavior such as digging, jumping, chewing, etc:

List of Current Pets

Pet #1 Type:
DogCat

Pet #1 Sex:
MaleFemale

Pet #1 Spayed/Neutered?
YesNo

Pet #1 Age:

Pet #2 Type:
DogCat

Pet #2 Sex:
MaleFemale

Pet #2 Spayed/Neutered?
YesNo

Pet #2 Age:

Pet #3 Type:
DogCat

Pet #3 Sex:
MaleFemale

Pet #3 Spayed/Neutered?
YesNo

Pet #3 Age:

Are your pets currently up to date on vaccinations?
YesNo

Do you give your pets heartworm preventative?
YesNo

Do you use flea/tick preventative?
YesNo

Veterinarians First Name

Veterinarians Last Name

Veterinarians Phone

Do your pets have licenses/identification/microchips?
YesNo

Do your pets socialize with other dogs?
YesNo

How do your pets react around other dogs

Why are you interested in fostering a dog?
Companion for other dogCompanion for childrenDesire to help animals in need

Please indicate Preferences:
Adult DogsOlder PuppiesLittersLarge DogsMedium DogsSmall DogsNo preference

Are you willing to foster the dog until he/she is adopted? (required)
YesNo

Anything else you would like us to know?

Reference #1 (First of two references...non-family members).

Please list a reference that can attest to how you are with animals.

First Name:(required)

Last Name:(required)

Relationship:(required)

Street Address:(required)

City:(required)

State:(required)

Phone:(required)

Reference #2 (Second of two references...non-family members).

Please list a reference that can attest to how you are with animals.

First Name:(required)

Last Name:(required)

Relationship:(required)

Street Address:(required)

City:(required)

State:(required)

Phone:(required)

Where did you hear about us? (required)
Adoption eventFacebookTwitterVetPetfinderReferenceI am a previous adopterPatchOther

If "other", please explain:(required)