First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone*

Which dog are you interested in fostering? (You do not have to choose a specific dog)*
Choose an animal: ***Any Dog/Not Listed Baxter Bluey Bobby Bonsai(Tabby ) and Mr Wick ( Black ) BONDED PAIR Brody Cooper Dixon Duke Felix Fiona Flash Jasper and Jett BONDED PAIR Juliana Kiki Mari Mr Wick (black) and Bonsai (tabby) BONDED PAIR Odin Rusty Poodle Sandy Spicey Wheezy

List the names of any other dogs you are interested in fostering, or describe the type of dog you are interested in fostering

Applicant Date of Birth*

Applicant Occupation (if retired, student or other please describe)*

Employer Name (retired, student, etc)*

Employer Phone Number (type N/A if retired, student or self-employed)*

PERSONAL REFERENCE #1: Name, Relationship to you, Address and Phone Number ***(Only one (1) can be a family member who DOES NOT live in the same household as you) LET THEM KNOW WE WILL BE CALLING*

PERSONAL REFERENCE #2: Name, Relationship to you, Address and Phone Number ***(Only one (1) can be a family member who DOES NOT live in the same household as you) LET THEM KNOW WE WILL BE CALLING*

Veterinarian's Name, Address and Phone Number (if more than one please list all), if None enter NONE.*

If you do not have a Veterinarian reference - we require a 3rd PERSONAL REFERENCE: Name, Relationship to you, Address and Phone Number *** (not a family member) LET THEM KNOW WE WILL BE CALLING

PET HISTORY: List all animals (current pets first followed by pets that have passed away) that have resided with you within the past 10 years. For each, include ALL of the following information: (1) Type of animal; (2) Breed; (3) Name; (4) How long they resided with you; (5) Were they up to date with inoculations; (6) Spayed/neutered? If not spayed/neutered or were not up-to-date with inoculations, please explain. (7) Is the pet alive or deceased?; If the pet is not deceased, but no longer living with you, please explain. If you have never owned a pet before, enter NONE * *

Do you have any cats? Are the cats de-clawed? *

List ALL people living in the home (1) NAMES (2) RELATIONSHIP TO YOU (3) AGE - If you are the only household member Answer: NONE*

Who will be primarily responsible for caring for the dog?*

In what type of home do you live?*
Choose one: Single Family Condo Townhouse Apartment

Do you own or rent your home?*
Choose one: Own Rent

HOME: Is the applicant listed the owner/renter of the home? If not, list owner's name and phone # here, they must approve adopting a dog.

If you rent or have an HOA, provide 1. Landlord/Management Company Name 2. Phone Number

Do you have a fenced in backyard? If so 1.Full or Partial 2.What type of fence and how high - if you have NO fence Answer: NONE*

How do you plan to exercise your dog*

On average - how much time will the dog spend alone during the day?*

Where will the dog be kept when you are NOT at home?*

Where will the dog sleep at night?*

Which of these best describes your reason for fostering?*
Choose one: I am interested in fostering because I would like to possibly adopt my foster dog. I am NOT interested in adopting at this time, but would like to foster a dog in need to help get them adopted.

Are you willing to foster a senior dog?*
Choose one: Yes No

Are you willing and able to foster a dog that must be an ONLY PET because he/she does not get along with other dogs or cats?*
Choose one: Yes No

If the dog has to be separated from other animals in your home, do you have an area to do so and are you willing to manage this process if needed?*

Are you willing/able to foster a special needs dog? (i.e. requires daily medication, undergoing medical treatment, needs to recover from surgery, blind, deaf, etc.)*

Are you willing/able to hospice foster (foster a terminally ill dog)*

Describe any obedience training experience you've had, or past personal experience with animal behavioral or medical issues?*

Are you willing/able to work with a dog that requires some basic obedience training?*
Choose one: Yes No

Are you willing/able to foster and work with a dog that requires some house-training?*
Choose one: Yes No

If you want to foster puppies, describe any prior experience you have had training puppies.

Are you willing to bring your foster dog to be showcased at one of our weekend adoption events AT LEAST ONCE a month?*
Choose one: Yes No