First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Cell Phone

Your full name:*

Home address (street, city, state, zip):*

Age or DOB:*

Home phone number with area code:*

E-mail address:*

Why do you want to foster a dog?*

How did you hear about us*

Name and address of employer:*

Full name of spouse/significant other (if none, write "none"):*

Their date of birth:

What is your Spouse/significant other employer? If none, type none*

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

If you rent, please enter your landlord's name and phone number*

Length of time at current home:*

Do you intend to move soon?
Choose all that apply: Yes No

List the names and ages of other human members of your household. If there are none, then write "none."*

Is everyone in the household on board to fostering a pet?

Total Yearly household income:*

Do you or anyone in your household have allergies or asthma?

If yes, explain.

List all pets that currently live in your home: Pet's name, type (dog/cat/etc.), sex, state if spayed/neutered, inside/outside/both, age. If none, write "none."*

Is the animal spayed/neutered?

List all present and/or previous Veterinarian(s) used. Include phone numbers and addresses (advise your Veterinarian(s) that we will be calling—if they are aware, it will speed up the approval process). If none, then write "none."*

List all pets you have owned in the past five years that no longer live with you. Include pet's name, type, sex, whether spayed/neutered, kept inside/outside/both, and what became of the pet. If none, write "none."*

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

Where will the animal be kept when you are not home*

Where will the animal be kept when you are home*

Where will the animal sleep*

Will you take your dog for daily walks?

Is your yard fenced*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What type of fence*
Choose one: Privacy Chain Link Invisible

What is the height of the fence*

Have you ever given up a pet? If yes, please explain*

Foster Animals may take time to adjust to the new surroundings. Are you willing to be patient during this time?

Are you willing to work with the foster and take them to training classes, walking, instill confidence?

List at least one reference (who is not a family member)*

I certify that the information entered on this applicant is true. Enter your name and date*