FOSTER APPLICATION

Date*

Date

Dog of Interest to Foster or Type of Dog to Foster*

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Date of Birth*

Phone Number*

Area CodePhone Number

Alternate Phone Number

Area CodePhone Number

Email*

example@example.com

Person to contact in case of Emergency (name with phone number)

Home Details*

	Home Type	Own	Rent
House
Condo
Apartment
Mobile Home
City
Subdivision
Rural

Type of Yard Security*

	Yes
Chain Link Fence
Wood Privacy
4 Foot
5 Foot
6 foot
Invisible Fence
Overhead Cable
Tie-out
Is method indicated available and secure NOW
OTHER...please describe in Comments

If you RENT, give Landlord Name & Phone Number & Explain the Terms in your lease in regard to having animals*

Are there any Breed Restrictions in your community? If YES, please explain*

List ALL persons living with you with AGE & RELATIONSHIP*

Is EVERYONE in your household aware & in agreement to caring for a foster animal? If NO, please explain. Also, share what your interest is in fostering a dog in your home.*

Please list ALL animals living in your home with NAME, BREED, AGE, VETTING STATUS (Spay/Neuter & Vaccine Status) & OUTSIDE on your property (i.e. chickens, farm animals, feral cats)*

Please list the PAST animals you have had in the last 5 Years, what happened to them & WHEN

Your VETERINARIAN & Phone Number (call your vet to provide permission for them to talk to us)*

(Name and Phone Number)

Describe your & your family's lifestyle. Do you work outside of the home? How many HOURS A DAY will the Foster Dog be left alone (During week & weekend). Do you leave town for trips?*

What enrichment & training are you willing to provide the dog? NOTE - we do not support taking dogs to dog parks or introductions to other animals without prior permission.

Leash walkingTeaching basic commandsExposure to different social settings, such as; pet supply store, being walked in a different area that the dog is used to, car rides & exposure to different peopleTeaching fetch or FrisbeePotty trainingCrate trainingOther

While left alone, where will the Rescue Dog be kept?*

Rescued dogs need acclimation/decompression, guidance & patience. What behaviors are you unwilling to work with?*

How will you Respond to CORRECT UNWANTED BEHAVIORS & are there any behaviors you would NOT be willing to work on correcting?*

It is suggested to allow a dog to gradually get acclimated to a new environment. Are you willing to possibly crate & rotate the dog with your own animals for a period of time?*

Do you UNDERSTAND most times a complete history and temperament of a Rescue Dog may not be known? Even surrendered dogs do not always have a truthful history provided to the rescue.*

YESNOI ONLY WANT TO FOSTER A DOG WITH A KNOWN HISTORY

Are you willing to work with us to correct any possible behavior problem*

YESNOI ONLY WANT TO FOSTER A DOG WITH NO PROBLEMS

Are you able to TRANSPORT dog to vet and adoption events?*

YESNO

Do you have any CONCERNS about fostering a dog or concerns with the possible interactions this Rescue Dog could have with any of your animals? If so, please explain.*

Please give a brief summary of your experience with what breeds of dogs & any fostering experience you may have. Please include type of dog you are interested in fostering, also.*

Do you have any PHYSICAL LIMITATIONS or HEALTH PROBLEMS that could hinder you from properly caring for & exercising a dog? (If YES, please explain)*

Are you a member of any OTHER RESCUES? (If YES, which one(s)?*

Please provide 3 REFERENCES (1 Neighbor if possible/NO Relatives) Include NAME, PHONE NUMBER & RELATIONSHIP*

COMMENTS

If I am accepted as a foster, I am aware that by signing this form, I agree to provide a safe & healthy indoor environment for the dog in my care for Streethearts Animal Rescue. I agree to notify a Streethearts Animal Rescue Administrator of any concerns, such as; illness, escapes, injuries or any other concern pertaining to my fostered dog as soon as possible. I also understand that the dog is solely owned by Streethearts Animal Rescue and may be removed from my premises at any time. I understand the stray/foster animal I will care for is to stay in my possession & not be transferred to any other person, rescue or shelter without the consent of Streethearts Animal Rescue. I understand that by fostering for Streethearts Animal Rescue that if I have interest in adopting my fostered dog that it would be reviewed by the board to determine if my home would be the best match for the dog, and also understand, the full adoption fee will apply unless decided differently by the board, otherwise.

By submitting this application, I affirm that the facts set forth in it are true and complete to the best of my knowledge. I understand that if I am accepted as a foster, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

Although Streethearts Animal Rescue will provide all materials & vetting, I agree that upon the signing of this contract that I am taking full responsibility of the physical care & behavior of the above named dog or any future dog. Streethearts Animal Rescue shall be held harmless from and against any and all claims and damages of every kind, for injury to any person or persons and for any damages to or loss of property, arising out of or attributed to, directly or indirectly, from having this above named dog or ANY future foster/stray dog you may have in your possession.

I, , agree with the above terms of fostering a dog(s) for Streethearts Animal Rescue and confirm my agreement by signing below.

Signature*

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