Name (First and Last):

Address:                   

City, State, Zip:         

Phone Number:         

Email Address:         

We do much of our communication by email. How often do you check email?

Are you the head of household? Select One Yes No

If not, head of household must fill out this application or we will not consider it even if you are of an adult age living in the home.

Please list ALL of the animals (dogs, cats and rabbits) you have had in the past 5 years and that you currently own. (Start with your current pets). Failing to include an animal will void a this application.

How many adults are in your household?

What are the ages of the adults?

How many children?

Ages of the children?

If there are no children do you expect children in the next year? Select One Yes No

Has every member of your family agreed to foster?  Select One Yes No If this has not been discussed at great length, please complete application when that has occurred.

Do you have a planned vacation in the next month? Select One Yes No

Are you prepared to foster immediately and take your pet home?  Select One Yes No

If not, when?    If not within the next 7 days, please complete this application when you are prepared to do so.

Does any member of your family have allergies or asthma? Select One Yes No

If yes, please explain:

Is someone home during the day? Select One Yes No

If yes, who?

How many hours a day will this pet be alone during the day?

When I am home, this pet will be kept: Select One In the House In the Garage In the Yard In an outdoor kennel Outside on a Tie Out Inside in a Crate

When I am not home, this pet will be kept: Select One In the House In the Garage In the Yard In an outdoor kennel Outside on a Tie Out Inside in a Crage

What type of home do you live in? Select One House Condo Apartment Duplex Mobile Home Townhouse

Do you Own or Rent? Select One Own Rent

If you rent, do you have permission from your landlord to have pets? Select One Yes No

If you rent, please provide your landlord's information (Name, Phone Number)

Where will this pet sleep?

Do you have a securely fenced yard?  Select One Yes No

If yes, what type? Select One Block Wall Privacy Wood Picket Wood Chain Link Wire Other (explain) No Fence   If other, explain:

What is the height of your fence at the lowest point?

Do you have a pool?  Select One Yes No

If yes, is the pool gated?  Select One Yes No

Are you willing to housebreak a dog?  Select One Yes No

How will you deal with the following issues?  Please do not write "training".  We are looking for specific ways you will deal with each of these issues.  Please be thorough.

Chewing:

Digging:

Barking:

Housebreaking:

Have you ever had to give up a pet? Select One Yes No

If yes, When?    Why?

Will you consider fostering a dog who needs daily medication?  Select One Yes No

Are you interested in fostering a Mom and a litter of pups?  Select One Yes No

Are you interested in fostering a pregnant Mom who will whelp at your home?  Select One Yes No

Are you interested in fostering a large breed, a small breed, or does it not matter?  Select One Small dogs Large Dogs Does Not Matter

Are there any breeds that you are opposed to fostering?

What is your level of experience with dogs?

Are you willing to take dogs directly from the shelter and provide the initial assessment of the dog and evaluation, or do you prefer to take a dog once he/she has already been in another foster home? (Please explain)

How did you hear about our rescue organization and about fostering?

Thank you for your willingness to help save the life of a dog.  It is through foster homes that we are able to save the animals that we have saved and continue to save in this rescue.