Foster Application Form

Are you aware of the BTRM adoption donation of $450.00*

Full Name*

First NameLast Name

Date of Birth*

MonthDayYear

Co-Applicant/Partner Name*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home*

Area CodePhone Number

Phone Number - Cellular

Area CodePhone Number

When is the best time to call?*

E-mail*

If you use facebook, what is your facebook user name?*

What is your occupation/title?*

Name of Employer:*

Length of time at current employer*

Co-Applicant/Partner Occupation Employer

Are you financially ready for a Bull Terrier?*

Is there a specific Bull Terrier you're interested in and if so who?*

What do you think a rescue Bull Terrier needs (you can pick more than one)*

Explain your choice(s) to the previous question*

What type of personality & activity level would you prefer your new Bull Terrier to have?*

Bull Terriers can be stubborn. Bull Terriers in rescue even more so. Please describe how you would deal with a difference of opinions with your Bull Terrier (ie he wants to eat your shoes, but you don't want him to eat your shoes) *

Do you live in a:*

Do you:*

OwnLive with ParentsOtherRent (must be able to get a landlord release)

Number of steps/stairs to get in/out of home:*

Number of years at current address*

Do you have plans to move in the next year?*

Are all household members in agreement on welcoming in a Bull Terrier?*

Do you have a fenced yard? If yes, please describe the height, material, shared/not shared, whole/partial or electric? (please note, not all of our dogs need a fenced yard)*

Household Setting*

RuralSuburbanUrban

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

Does Anyone in your Household have Allergies to Animals?*

YesNo

Please List all animals currently in your household (include Name, Breed/Species, Age, Altered, UTD Vaccines, Heartworm)*

Please List the animals you've owned previously and what happened to them:*

Please List all the animals currently on your property outside (ie avian, porcine, bovine livestock, and/or feline etc)*

Do you agree to keep your Bull Terrier from ingesting/being given the sedative called acepromazine (also known as acetylpromazine, ACE, ACP, and PromAce), in pill form, whether DIRECTED OR PRESCRIBED OR GIVEN BY A VETERINARY PROFESSIONAL OR OTHERWISE? Please explain if no*

If you discovered you had to move & are having difficulty finding a dog-friendly home, what would you do?*

In your mind, what circumstances justify giving up a pet?*

Have you ever had to surrender, give away, sell or re-home your own pet?*

Why do you and/or your family want a Bull Terrier?*

Do you have prior Bull Terrier experience?*

How would you react if you came home or found that your Bull Terrier had destroyed something or had an accident in your home?*

Who will be the primary person responsible for the Bull Terrier? [Name & Relationship:(ex. Bob Smith, self; Jane Smith, daughter)]*

Where will your Bull Terrier stay during the day, and where will he/she sleep at night?*

How many hours a day will your bull terrier be left alone. Please elaborate. *

Bull Terriers have genetic tendencies, such as pest control, using their humans as furniture, involving themselves in everyone's business and random exuberant celebratory "zoomies" aka "hucklebutts". What are your thoughts on this?*

Do you have any preferences to age, gender or size? If so what are they?

Are you willing to take the bull terrier to the vets (that we pay for until adoption is complete) and treat them until they are cleared for health? This can be as minimal as monthly preventatives all the way up to post surgical care, medicating daily cleaning wounds etc. Please explain what you are and are not willing to help with.

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

YesNo

Have you had any experience with behaviorally unsound, traumatized or neglected/abused dogs? If Yes please explain in detail.

How do you plan to enrich your foster? Please list any activities or duration and numbers of daily walks, types of "brain games" etc. Feel free to elaborate..*

Are you willing to take your Bull Terrier to obedience training if needed? (if no, please explain)*

Please describe your weekend activities*

How often do you vacation? Where will your Bull Terrier stay during this time?*

Are there loose or wild animals in your neighborhood? (if yes, explain)*

Is there a leash law in your town?*

Are there breed-specific laws in your town?*

Are you willing to have a member of BTRM visit your home?*

Microchip contact information to BTRM dogs remains to the BTRM even once formally adopted. This is for the safety and security of the dog should anything unfortunate happen to the adopter(s). For a fee of $25.00, BTRM can add the adopter(s) as second or additional contact. Are you okay with this?*

YesNo

BTRM does not approve, condone or allow the use of off-leash dog parks for our Bull Terriers. Do you acknowledge and agree to abide by this rule?*

How did you hear about the Bull Terrier Rescue Mission?*

Please provide your Veterinarians name, location and contact info (phone number)*

1st Personal Reference, name relationship to applicant and contact information (email or phone number)*

2nd Personal Reference, name relationship to applicant and contact information (email or phone number)*

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 BULL TERRIER RESCUE MISSION, INC. 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 the BULL TERRIER RESCUE MISSION, INC 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 BULL TERRIER RESCUE MISSION, INC from any liabilities or damages that may be incurred because of fostering such dog(s). I agree to have BULL TERRIER RESCUE MISSION, INC 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 BULL TERRIER RESCUE MISSION, INC and try to give BULL TERRIER RESCUE MISSION, INC a 2 week period to try and find another suitable foster for the dog(s).

Your name*

Date

MonthDayYear

E-mail*