[Imported Form] Foster Application - The Last Resort Animal Rescue and Sanctuary

Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long at this address?*
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number
E-mail*
Up until what time at night can we contact you?*
Name and ages of ALL occupants in household (including yourself)?
Is your entire family aware of your decision to foster a dog in your home?*

YesNo
Are any members of your household allergic to animals?*

YesNo
If yes, please explain:
Place of employment:
How many hours will your dog be alone in a typical day?*
Please indicate which best describes your current living situation:*
Do you:*
If you rent, Landlord’s name & phone:
What type of environment?*
Do you object to having TLR conduct a home visit and/or periodic follow-up visits?*

YesNo
Do you currently own a pet?*

YesNo
Over the past 5 years, how many pets have you owned? Include current pets.
List each individually including breed, age, still living with you (if not, why?)
Are your current pets spayed/neutered?*

YesNoN/A
If no, please explain:
Are your current pet’s vaccinations current?*

YesNoN/A
If no, please explain:
Were your previous pets spayed and neutered and up to date on vaccines?*

YesNoN/A
If no, please explain:
Do you currently provide your pets with monthly heartworm and flea/tick prevention?*

YesNoN/A
If no, please explain:
What brand of food are you currently feeding your pets?*
If you currently own a dog, how does he or she react to new dogs? Any behavioral issues?
How do you currently deal with any behavioral issues that come up? (What is your style/method of training?)*
Have you or any member of your household been accused/charged of animal cruelty or negligence?*

YesNo
If yes, please describe:
Who is your current or most recent veterinarian? Please list Name, Address and Phone # (PLEASE MAKE SURE YOU CALL YOUR VET TO GIVE THEM PERMISSION TO RELEASE YOUR INFORMATION, OTHERWISE WE WILL BE UNABLE TO PROCESS YOUR APPLICATION)
How were you referred to The Last Resort Rescue?
What type/breeds of animals would you be interested in fostering? (Check all that apply)*

CatsCats w/KittensPregnant CatsSmall DogsMedium DogsLarge DogsDogs w/PuppiesPregnant DogsSpecial Needs AnimalsMaleFemale
Please check which level of foster care you would like to provide:*

Emergency (maximum of 1-2 weeks)Interim/Short term foster (maximum of 2-3 months)Long term care (up to 6 months- can be extended if chosen)
Do you have a yard?*

YesNo
If so, is it fenced and how tall?
If you do not have a fence do you plan on putting one up?

YesNoN/A
If so, when and what type?
How do you currently exercise your dog(s)?*
Do you have a homeowners or renters insurance policy?*

YesNo
Name and phone # of insurance company:
Do you have a city or county ordinance that limits the number of dogs you are allowed to have in your home?*

YesNo
If yes, how many are you allowed to have?
Do you plan to use a crate, if not, where would the dogs stay while you are not at home?*
Where will the dog sleep?*
Dogs are not to be chained or tied and left outside unattended at any time.*

I agreeI disagree
Have you fostered any animal in the past?*

YesNo
If yes, what kind?
Through which agency (name, phone number)?
What are you willing to provide for a foster animal? (check all that apply)*

FoodShelterTrainingActivities
If other than above, please list below:
Are you willing to provide transportation to and from the vet, adoption sites, etc. as needed?*

YesNo
List any Humane Societies, Organizations, Breed, or Training Clubs you are associated with:
Please know that we are potentially screening apps for your foster dog. If at any time you want to adopt him/her, you must let us know immediately, even if you are just considering it.*

I understand
Please provide 3 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved. PLEASE BE AWARE: If your references are not easily reachable or do not reply in a timely manner, it will delay your application. If multiple references do not reply, your application will be filed on HOLD. Please choose your references carefully and be sure to list the correct contact numbers.
Reference #1*
First and Last Name & Relationship to Self
Reference # 1 Phone Number*

Area CodePhone Number
Reference #2*
First and Last Name & Relationship to Self
Reference # 2 Phone Number*

Area CodePhone Number
Reference #3*
First and Last Name & Relationship to Self
Reference # 3 Phone Number*

Area CodePhone Number
Do you understand that throughout the foster period, you are ABSOLUTELY NOT permitted to give the dog to anyone else, adopt it out, or bring it to the shelter for any reason? It may only be given back to us!!*

YesNo
Anything else you would like to say, please note it here:
Should be Empty: