Foster Application form

Full Name*

First NameLast Name

Pet Interested In fostering

Additional Information to match the right foster animal

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Age

E-mail*

example@example.com

Phone Number - Cellular

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Do you live in a:

Do you:

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

Describe your Homes Activity Level

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Does Anyone in your Household have Allergies to Animals?

YesNo

Family members agreeable to foster a Dog?

YesNo

Please List Current Pets (Please include Name, Breed, Age, Spay/Neuter, Sex, UTD Vaccines) *

Do you have a preference in sex of foster?

MaleFemaleNo Preference

Are you willing to foster a dog of any age?

YesNo

If not, what age would you consider?

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

SmallMediumLarge

Are you willing to take your foster dog to vet appointments at a convenient time for you?

YesNo

Do you drive or have access to a vehicle to bring your foster to events and appointments

YesNo

If No please explain

Are you willing and able to medicate your foster, even if it just a monthly heartworm preventative?

YesNo

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?

YesNo

Have you had any experience with with an emotionally or physically neglected or abused dog?

YesNo

If Yes please explain

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

YesNo

Do you have a fenced yard?

YesNoPartial

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

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

Please list 3 personal references with names, addresses, phone numbers and how related. We prefer it not to be relatives. Are you ok with this?

YesNo

Vet Reference:

Name

Phone Number

Area CodePhone Number

Reference #1: Full Name

Full Name

Relation to applicant(s):

E-mail

example@example.com

Phone Number

Area CodePhone Number

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

example@example.com

Phone Number

Area CodePhone Number

Phone Number

Area CodePhone Number

By sending this electronically, I acknowledge that I have completely read this questionaire 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 Team Memphis Rescue & Support 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 electronically, I agree to relase and covenant to hold harmless Team Memphis Rescue & Support and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog.

I accept full responsibility for the dog(s) actions at all times, and release Team Memphis Rescue & Support from any liabilties or damages that may be incurred because of fostering such dog(s).

I agree to have Team Memphis complete reference call checks and conduct a home visit inspection to be able to approve my foster application.

I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to Team Memphis Rescue and try to give Team Memphis Rescue a 2 week period to try and find another suitable foster for the dog(s).

Date

MonthDayYear

Your name*

E-mail

example@example.com

FOSTER APPLICATION FORM