FOSTER APPLICATION

    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)

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

    Are you willing to attend safety training? (required)

    Will you agree to a home visit? (required)

    Do you Own or Rent? (required)

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

    Name of Landlord

    First Name (required)

    Last Name (required)

    Phone of Landlord (required)

    Do you have homeowners/renters insurance? (required)

    Name of insurance company:

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

    Name of insurance company:

    Which best describes your household? (required)

    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)

    Is your yard fenced? (required)

    Fence Height (ft.)

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

    Have you ever attended Obedience Training Classes? (required)

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

    Have you ever had a dog before? (required)

    How many?

    Size of Dog(s):
    SmallMediumLarge

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

    If so, how did you address them?

    If you have children, have they had dogs?

    Are your children afraid of dogs?

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

    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:

    Pet #1 Sex:

    Pet #1 Spayed/Neutered?

    Pet #1 Age:

    Pet #2 Type:

    Pet #2 Sex:

    Pet #2 Spayed/Neutered?

    Pet #2 Age:

    Pet #3 Type:

    Pet #3 Sex:

    Pet #3 Spayed/Neutered?

    Pet #3 Age:

    Are your pets currently up to date on vaccinations?

    Do you give your pets heartworm preventative?

    Do you use flea/tick preventative?

    Veterinarians First Name

    Veterinarians Last Name

    Veterinarians Phone

    Do your pets have licenses/identification/microchips?

    Do your pets socialize with other dogs?

    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)

    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)

    If "other", please explain:(required)