First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
County*
Email*
Home Phone*
Work Phone* x
Cell Phone*
Text/Pager Email
Do you own or rent your home? If you rent you will be required to furnish a copy of your lease regarding allowance of pet.*
Please list all people in the household and include ages.*
Is anyone in your household allergic to dogs?
Has anyone in your household ever been convicted of animal cruelty or neglect?
Have you fostered for any rescue organizations in the past?*
How many hours a day will the dog/s be left alone?* Choose one: none 2 3 4 5 6 7 8 9 10+
If yes, which organizations?*
Please list all pets in the household including ages and breeds: one per line*
Are all pets spayed/neutered*
Please provide the name of your veterinarian:*
Please provide phone number of current veterinirian:*
Where will the dog be kept when you are at home?
If confined to certain areas please specify what area(s) of the house.*
Where will the dog sleep at night?
If confined to certain areas please specify what area(s)of the house.
Where will the dog be kept when you are NOT at home?
If confined to certain areas please specify what area(s) of the house.
If you will be crating the dog, how many hours a day will the dog be crated?*
Do you have a fenced in yard?
If yes, what type and what height?*
How do you plan to exercise your foster dog on a daily basis?
What age dogs are you looking to foster? Choose all that apply: Under one year Under 5 years Middle age Adult Senior No Preference
What size dog are you looking for?
Must your foster dog be housebroken?
Are you willing to allow potential adopters to visit the dog in your home?*
