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Please note:
All dogs will be spayed or neutered
prior to placement. |
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Fill in all
fields, fields that do not concern you apply N/A |
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Today's Date: |
mm/dd/yy |
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Part 1 |
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Full Name: |
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Title: |
mr/mrs/miss/ms |
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Street Address: |
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Address (cont.) |
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City: |
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State: |
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Zip Code: |
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Work Phone#: |
please
include area code |
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Home Phone#: |
please
include area code |
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Cell Phone#: |
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Email Address: |
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Occupation:: |
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Date of birth: |
mm/dd/yy |
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Gender: |
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Part 2 |
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If you have fostered before please
give as much information as you can,
e.g., for whom, contact of that
organization, when, etc....: |
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Please provide the name of the dog
you are interested to foster: |
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Do you prefer Male or Female? |
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Do you prefer an adult or puppy? |
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Dog's living situation: Indoor? |
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Dog's living situation: Outdoor? |
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Where will the dog be when you are
not home? |
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If you have chosen other please
explain. |
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How many hours a day will the dog be
home alone? |
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How will you exercise the dog? |
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What is your yard size? |
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Is the yard enclosed by a fence? |
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Please explain the type and size of
fence |
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What type of home do you live in? |
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If you have chosen other please
explain. |
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Do you own the property? |
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If other please specify: |
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If you are renting please verify the
landlord's name and phone number for
verification: |
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Home Location: |
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Does your municipality have breed
specific restrictions? |
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If so, please describe the nature of
the restrictions: |
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How many individuals under 21 in
your household? |
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What are the ages of the individuals
under 21? |
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you have other dogs? |
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answering yes, please specify how
many you have: |
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What are their sexes? |
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How many are Spayed or neutered:
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Please specify breeds and ages of
the other dog/s: |
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you had other dogs in the past,
please let us know the current
deposition of those dogs. |
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What other kind of animals do you
own? |
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relate any prior experience you have
had with the breed of dog you wish
to foster: |
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Please supply the name and phone
number of your current veterinarian,
and employer, clergyman, or anyone
not related to you who can attest to
your character: |
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Any additional information you would
like to provide: |
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