First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone*

Who is your employer?*

Years Employed

Why do you want to foster at this time?*

What preparations have you made or will you make for your new pet?*

Describe your plans for your dog - Watch Dog, Companion, Family Member, Hunting Dog, Child's Pet, Guard Dog, Fighting Dog, Outside Dog, etc. Please explain in detail.*

Who will have primary responsibility for your new pet?*

Have all adults in the household been consulted and do they agree to this adoption?*
Choose one: Yes No

Are you financially able to take care of an ill or injured pet (which may cost up to thousands of dollars)?*
Choose one: Yes No

Please describe the extent of care that you are willing to provide should your dog have special needs now or in the future.*

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Other - please explain

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

If renting, do you have permission to keep pets?
Choose one: Yes No

Has the pet deposit been paid?
Choose one: Yes No N/A

Landlord's Name

Landlord's phone number

Will the adoption of this pet comply with your subdivision/condo/apartment regulations?
Choose one: Yes No

Do you have a yard?*
Choose one: Yes No

If yes, please select one of the following*
Choose one: Partially Fenced Completely Fenced No Fencing

What type of fence
Choose one: Privacy Chain Link Invisible

What is the height of the fence*

Have you ever owned a pet?*
Choose one: Yes No

Please list your past and current pets. Include the following information: Name, Sex, Age, Type (dog, cat, etc.), Breed, Size, Status (living, deceased). If none please enter N/A.*

Have you ever given up a pet for any reason?*
Choose one: Yes No

If yes, please explain what happened to the pet. (Brought to shelter, found a new home, etc.)

Please indicate if any of the following apply:

If you have had a pet die of disease, please indicate the disease.

Are all your pets current on their vaccines?*
Choose one: Yes No

Are all your pets spayed or neutered?*
Choose one: Yes No

Are all your pets on heartworm prevention?*
Choose one: Yes No

Please provide your veterinarian's name and phone number.*

How many people live in your home?*

What are their ages?*

If you have children, have they been taught to treat animals with respect and kindness?
Choose one: Yes No

Do any members of your household have known pet allergies?*
Choose one: Yes No

Do you plan to take this pet to formal training classes?*
Choose one: Yes No

If yes, please explain

Where will this training take place?

If you do not plan to participate in formal training, how do you plan to train your new pet?

Where and how often do you plan to exercise your pet?*

Do you have reliable transportation?*
Choose one: Yes No

If applicable, how many hours per day will your pet be crated or kenneled? If no crate will be used please enter N/A.*

What size is your crate/kennel?

You may need to house train your new puppy or dog. What is your training method?*

Can you invest the time and effort necessary to allow this pet to adjust to a new home?*
Choose one: Yes No

How much time are you willing to give your new pet to adjust to his/her new home?*

Have you ever adopted a rescue before?*
Choose one: Yes No

What do you consider valid reasons to give up a pet? Please select all that apply.

Please explain any selections.

Describe what you will do if your pet displays any of the following behavior: Digging Chewing Not getting along with other pets Difficulty adjusting to household *

Would you seek additional training?
Choose one: Yes No

If needed, how would you discipline your pet?*

How many hours a day will this pet be left alone?*

Where will you keep your pet when you are not home?*
Choose one: Outside Crated Free Roam of House Enclosed Kitchen or Laundry Room Other

How many hours in a 24 hour period will the pet spend Indoors or Outdoors?*

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

If outdoors, will the pet be left alone or with family?

Where will this pet sleep at night?*
Choose one: Crate Kitchen or Laundry Room Outside Garage Master Bedroom Child's Bedroom Pet's Own Bed Yours or Child's Bed Other

Who will care for the pet when you go on vacation?*

What would you do if this pet became lost?*

Do you know that dogs and cats can live as long as 15 years or more?*
Choose one: Yes No

Are you willing to accept responsibility for a living creature for 15 or more years?*
Choose one: Yes No

Would you object to a home visit?*
Choose one: Yes No