Date
*
MM
DD
YYYY
Name
*
First Name
Last Name
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Work phone
*
(###)
###
####
Date of Birth
*
MM
DD
YYYY
How many people are in your household? What are their ages?
*
How many children are in your household? What are their ages?
*
Do you live in a house, apartment, condo, townhome, duplex?
*
How long have you been at this address?
*
Do you own or rent your home?
*
Own
Rent
If renting are there any pet restrictions?
Yes
No
If yes, what are they?
Do you currently have pets?
*
Yes
No
If yes, what kind of pets?
Please check all that apply
Dogs
Cats
Other
What are their ages?
If you have pets, are they spayed/neutered?
Yes
No
How long have you had each current pet?
Do you have a fully fenced yard?
*
Yes
No
If yes, what type of fence?
Chain link
Wood
Other
How high is the fence?
*
Fence Material (wood, chain link, brick, other)?
If you do not have a fenced yard, do you agree to keep your foster dog on leash at all times outside?
Yes
No
Who will be primary caretaker of your foster dog?
How would you describe your level of experience with dogs?
*
Please check all that apply
None
Had a childhood dog
Had one or more as adult
Have experience with powerful breeds
Have experience working with on-going medical problems with a personal dog
Have experience working at boarding kennel/resort/pet sitting services, training, etc.
Have experience working with behavioral problems with a personal dog
Have experience working in a veterinary hospital
Have previous foster/rescue experience
What size dogs do you have experience with?
*
Please check all that apply
Small dogs
Medium dogs
Large dogs
What breeds do you have experience with?
*
What types of dogs are you interested in fostering?
*
Please check all that apply
Adult dog
Puppies
Mother with nursing puppies
Sick/injured dog
Dog with behavioral issues
Long term hospice care
Bottle babies
How many hours during the average day will the dog spend without a human?
*
Where will the dog be when someone is home?
*
Where will the dog be when alone?
*
Where will dog sleep?
*
How long can you foster the dog for?
*
What situations do you feel unprepared for?
*
Please check all that apply
Excessive barking
Digging
Shy, fearful, under socialized
Not good with small animals/cats
Needs to be the only dog
Destructive chewing
High activity level
Not good with kids
Not housebroken
Resource toy/food guarding
Deaf/ blind
Administering medications
Is there a specific dog you are interested in?
Please tell us anything else you would like us to know
*
Please list two references
*
Include name, email, and phone number