Foster Application form

How did you hear about Hear No Evil

Full Name *

First Name Last Name

Age

E-mail *

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number - Mobile *

Area Code Phone Number

Alternative Contact No.

Area Code Phone Number

Drivers Licence #, State of issue and Expiry Date. *

What type of fostering are you considering *

Short Term (Less than 3 mthsoutl) Long Term (Greater than 3mths) Both short & long term Emergency

Why do you want to foster a deaf or special needs dog? *

Do you live in a: *

Do you: *

Own Rent Live with Parents Other

Do you have proof of Real Estate/Land Lord permission to have pets?

Yes No

Do you consent to a property check? *

Yes No

Household Setting *

Rural Suburban Urban

Describe your Homes Activity Level *

Busy/Noisy Moderate Comings/Goings Quiet 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? *

Yes No

Are all members of your Family agreeable to Fostering a Dog? *

Yes No

Please indicate your level of dog experience *

Do you currently have pets? Please list breed, age whether desexed and vacinated. *

Do you have a preference in sex of foster? *

Male Female No Preference

Are you willing to foster a dog of any age? *

Yes No

If not, what age would you consider?

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

Small Medium Large Giant

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. *

Please indicate which "special needs" you are happy to foster. *

Deaf Deaf & Blind Hearing but Blind Mobility issues Neurological issues Behavioural issues requiring medication and/or training Palliative care Happy to take any dog needing care.

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

Yes No

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

Yes No

If No please explain

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

Yes No

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

Yes No

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

Yes No

If Yes please explain

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

Yes No

Do you have a fenced yard? *

Yes No Partial

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

Are there any internal fences separating yards? If yes, please provide details. *

Is there shelter from all weather conditions? *

Yes No

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

What are your plans to exercise your foster? Please list any parks near by or trails, how many walks a day, approximate length, and activities such as agility. *

Are you happy for us to contact your current vet as a reference? *

Yes No

Vet Reference: Full Name

First Name Last Name

Vet Clinic

Phone Number

Area Code Phone Number

E-mail

General:

By sending this electronically, I acknowledge that I have completely read 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 HEAR NO EVIL animal fostered by me.

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

I am 18 years of age or older and have read, understood and agreed to the terms below.

I agree to have HEAR NO EVIL complete reference call checks and conduct a home visit inspection to be able to approve my foster application.

I agree to accept the animal into Foster Care until a new foster home is found, or until the dog is permanently adopted, whichever occurs first (Fostering Period),

The foster carer is responsible for the day to day love and care of the dogs, but the dog remains the legal property of HEAR NO EVIL.

Foster carers CAN NOT give away, sell, surrender to another organisation, or have the dog euthanised. Doing so will result in legal action.

I will notify HEAR NO EVIL within 7 days of any change to my contact details recorded above.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless HEAR NO EVIL and its 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 HEAR NO EVIL from any liabilities or damages that may be incurred because of fostering such dog(s).

Conditions of Care:

I agree to accept the animal in its current condition, health and behaviour.

I agree to maintain and house the animal in conditions explained to me by HEAR NO EVIL. The animal will become a member of our family and as such will be cared for with the comforts of home.

The information I have provided to HEAR NO EVIL as to the property on which the animal is to be housed, and my ability to maintain the animal in proper health, is true and not misleading in any way.

I agree not to house the dog at an alternative location or pass the dog into the care of another person, without the express consent of HEAR NO EVIL.

I agree not to take the dog out of the designated region without the express consent of HEAR NO EVIL.

I understand that HEAR NO EVIL may inspect the property on which the animal is to be housed (before and during) to ensure the animal’s safety and security and as a result of this inspection I may be requested by Hear No Evil to return the animal. In this instance I agree to return the animal requested to HEAR NO EVIL at a mutually convenient time and place.

I agree to continue monthly heartworm and flea treatment (due 1st day of every month), and quarterly gastro-intestinal worming treatment. (Where donations are available they will be passed on for foster carers use).

The dog will, at all times, wear a collar with an identification tag attached. Check Chain Collars are not permitted.

The dog will not be allowed off my property or allowed in any unsecured area without a collar and lead (Off-leash exercise in fully fenced dog parks is ok).

Health & Wellbeing:

I understand that all day to day costs associated with the care of the dog (such as food, worming treatment etc) are my responsibility and cost. (Where donations are available they will be passed on for foster carers use)

I agree to take the dog to a vet appointed by Hear No Evil for Vet appointments such as vaccination, de-sexing, annual health checks etc, and I understand that this cost will be covered by HEAR NO EVIL.

I agree to follow any instructions given by HEAR NO EVIL or HEAR NO EVIL's authorised vet in regards to health treatments for the dog.

I agree to make regular (Minimum fortnightly) contact with my Foster Coordinator to provide an update on the well being of the dog this includes providing videos and photos to be used for public use for their profiles and promotional material.

I agree to contact the Foster Coordinator immediately if the dog is sick, injured or experiencing difficulties settling in.

I agree to contact the Foster Coordinator immediately if the dog is involved in an incident causing harm to itself, another animal or person.

I agree to advise my Foster Coordinator should the dog require any veterinary treatment. I understand that unless injury or sickness is deemed to be caused by foster carer negligence, all veterinary costs will be covered by HEAR NO EVIL.

I agree to advise my Foster Coordinator if I require any short-term assistance to house the foster dog due to planned holidays etc. I will provide as much notice as possible.

Adoption enquiries:

I understand that should the Foster Coordinator receive adoption enquiries about the dog, I will be contacted.

I agree to make the dog promptly available for a meet and greet at a mutually agreeable time and location, and I agree to actively participate in the adoption process if required.

I agree that I will make the dog available at any adoption days, photoshoots or events where possible.

I understand that should another party be interested in adopting the dog, I may apply to keep the dog however this is subject to the terms and conditions of adoption, and payment of the full adoption fee for the dog.

Return of dog:

I agree to return the dog to HEAR NO EVIL upon request.

If during the Fostering Period I feel the animal is unsuitable for any reason I will contact my Foster Coordinator and arrange a mutually convenient time to return him/her to HEAR NO EVIL. I will try to give HEAR NO EVIL a 2 week period to try and find another suitable foster for the dog(s).

I indemnify HEAR NO EVIL, its directors, employees and volunteers for any liability, costs or expenses which arise as a result of my actions or omissions (including negligence) or the animal’s condition, health and behaviour while the animal is in my care.

Date

Month Day Year

Your name *