FOSTER APPLICATION

FOSTER APPLICATION

STREETHEARTS ANIMAL RESCUE FOSTER APPLICATION
Date*

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

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

Type of Yard Security*

Rows	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

Inground (not fenced)Inground (fenced)Above ground (secured)Above ground (access from house/deck)NO POOL
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?*
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
CRATERESTRICTED AREA (room in home)FREE ROAM OF HOMEBASEMENTGARAGE
Getting on furniture/bedsChewing on shoes/furnitureSheddingBarkingJumping on PeopleDiggingRough playPotty accidentsFence jumpingTimid/fearfulMouthinessAggressive
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 and rotate the dog with your own animals for a period of time in order to allow the dog to decompress & acclimate to a new environment and new animals?*
YESNOI ONLY WANT TO FOSTER A DOG WITH A KNOWN HISTORY (know that we cannot be held responsible for any details we are told about the dog)
YESNOI ONLY WANT TO FOSTER A DOG WITH NO PROBLEMS (know that there is always something to work out with acclimating a new dog to a new environment)
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 that 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. By signing below, I agree to the above disclosure, terms and conditions outlined above and acknowledge my commitment to providing a loving and safe home for any foster dog under my care with Streethearts Animal rescue. Please state your acceptance of this contract in the box below and provide your signature*
Signature*

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