Foster Application form

How did you hear about Charley's K-9 Rescue?

Full Name

First NameMiddle NameLast Name

Birthday

Date

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home

Area CodePhone Number

Phone Number - Cellular

Area CodePhone Number

Do you live in a:

Do you:

If Renting: Please indicate landlord contact information

Where do you work? How long have you been employed there?

Describe your Homes Activity Level

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

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm, Living/Deceased)

Over the past 5 years, how many pets have you owned? (not current)

Do you have a preference in sex of foster?

Are you willing to foster a dog of any age?

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

Please describe the type of dog you are willing to foster (Please include breed, coat length, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes.

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

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

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

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

Do you have a fenced yard?

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

Are You Looking to Foster Through Charley's Sober Companions? Click No If You Are Wanting to Foster Regularly. (This program is for recovering addicts)

Are your current pets up to date on all vaccines? Are they spayed/neutered?

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

Reference #1: Full Name

First NameLast Name

Relation to applicant(s):

E-mail

Phone Number

Area CodePhone Number

Reference #2: Full Name

First NameLast Name

Relation to applicant(s):

E-mail

Phone Number

Area CodePhone Number

Reference #3: Full Name

First NameLast Name

Relation to applicant(s):

E-mail

Phone Number

Area CodePhone Number