Foster Home Application

How did you hear about Leann's Animal Rescue?*

Full Name:*

Age:*

Email:*

example@example.com

Phone Number:*

Home Address:*

Do you live in a:*

HouseApartment

If renting, please provide landlord contact information:

Describe your home's activity level:*

Busy/NoisyModerate comings/goingsQuiet with occasional guests

Please list all people living in the household, their relationship to you, age, and genders:*

Does anyone in your household have allergies to animals?*

YesNo

Are all members of the household agreeable to fostering animals?*

YesNo

Please list all pets in the household, their age, breed, sex, and if they are spayed/neutered and UTD on vaccines:*

Do you have a preference of species you would like to foster? (select all that apply)*

DogCat

Do you have a preference of foster animal gender? (select all that apply)*

MaleFemale

Are you willing to foster an animal of any age?*

YesNo

If no, what age would you consider?

What size dog are you willing to foster? (select all that apply)*

SmallMediumLarge

Please describe the type of dog you are willing to foster (including coat length, personality traits, energy level, etc):*

Are you willing to take your foster animal to vet appointments?*

YesNo

Do you drive/have access to bring your foster to events and appointments?*

YesNo

If no, please explain:

Are you willing and able to give your foster any medications?*

YesNo

Are you equipped to train with love and patience (this includes potty training)?*

YesNo

Have you had any prior experience with an emotionally/physically neglected or abused animal?*

YesNo

If yes, please explain:

Are you willing to use a crate for a dog if recommended?*

YesNo

Do you have a fenced in yard?*

YesNoPartial

If fenced, please give details on height, material, # of gates, and if the gates are locked/lockable:*

How many hours in a day would the foster be left alone?*

What are your plans to exercise your foster? How many walks a day, length, and activities, etc:*

Please list 3 personal references, their phone numbers, and how they are related to you:*

By signing this application, I acknowledge that I have completely read the policies, procedures, and this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Leann’s Animal Rescue animal fostered by me.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form, I agree to hold harmless Leann’s Animal Rescue and it’s members from any claims, damages, costs, or actions incurred because of the care or actions of the foster animal.

I accept full responsibility for the animal’s actions at all times, and release Leann’s Animal Rescue from any liabilities or damages that may be incurred because of fostering such animals.

I agree to have Leann’s Animal Rescue complete reference call checks and conduct a home visit inspection to be able to approve my foster application.

I agree that if I am unable to foster the animal(s) any more that I will return the animal(s) to Leann’s Animal Rescue, and try to give Leann’s Animal Rescue a minimum of a 2 week notice in order to provide time to find another suitable foster for the animal(s

Printed Name*

Date*

Date

Signature*