Foster Application

How did you hear about Another Chance Dog Rescue?

Full Name *

First Name Last Name

Age *

Where do you work? *

Your job title? *

personal E-mail *

Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Home Number

Area Code Phone Number

Cell Number *

Area Code Phone Number

Do you: *

Own Rent Live with Parents Other

If Renting: Please indicate landlord contact information *

Describe your Homes Activity Level *

Busy/Noisy Moderate Comings/Goings Quiet with Occasional Guests

Do you live in a? Select one

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

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

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? *

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? We provide instructions and guidance. *

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? *

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.

Please list 2 personal references with names, addresses, phone numbers and how you are related. We prefer it not to be all relatives.

Yes No

Vet Reference if you have a Vet: Clinic Name and number

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number *

Area Code Phone Number

Reference #1: Full Name *

First Name Last Name

Relation to applicant(s): *

E-mail

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number *

Area Code Phone Number

Reference #2: Full Name *

First Name Last Name

Relation to applicant(s): *

E-mail

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

I understand that under no circumstances do I have permission to keep, withhold, adopt out, give away, hide, drop off in boarding, or relocate the animal(s) I am fostering. Permission to take foster dog(s) on vacation is required. ACDR will contact the appropriate authorities and report stolen property and let the Police handle the case should anyone withhold an animal (dog, puppy, cat, or kitten) for any reason whatsoever. Withholding one of our animals is a serious offense. We will prosecute.

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 ANOTHER CHANCE DOG 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 electronically, I agree to release and covenant to hold harmless ANOTHER CHANCE DOG RESCUE 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 ANOTHER CHANCE DOG RESCUE from any liabilities or damages that may be incurred because of fostering such dog(s). I agree to have ANOTHER CHANCE DOG RESCUE 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 ANOTHER CHANCE DOG RESCUE and try to give ANOTHER CHANCE DOG RESCUE a 2 week period to try and find another suitable foster for the dog(s).

Your name or nickname *

E-mail *