Foster Application
Miko's Sanctuary - Senior Dog Rescue
Name
*
First Name
Last Name
Email
*
example@example.com
Please let us know which pet(s) you are interested in fostering:
*
List the pet here by name. A list of adoptable pets is available on our website.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Tell us about the people in your household, including the number of members (adults, children, seniors, special needs) and their ages.
*
Please list your current pets, if none please list your most recent pets, and tell us a little about them (species, age, size/breed). Please include any prior fosters you have had and indicate they were fosters.
*
Please tell us more about your home (size, yard, etc).
*
Do you rent or own?
*
Rent
Own
Does your HOA or landlord allow pets? If so, do they have pet restrictions (such as breed or weight limits)?
*
Where do you plan to keep your pets when you are away from home?
*
A current veterinarian is required, especially if there are or have been other pets in the home. We will check vet references. If this is a first or only pet, staff may recommend vets in your area. Please provide your veterinarian's name and phone number below:
*
Veterinarian's name (please provide the name of the practice if you attend a multiple-doctor clinic.)
*
Veterinarian's phone number:
Emergency Contact: Please list a person to notify in case of an emergency.
*
Emergency Contact First Name
Emergency Contact Last Name
*
Emergency Contact Phone Number:
PLEASE READ BEFORE SIGNING: I understand that completing this foster questionnaire and application does not guarantee approval for adoption. Failure to provide contact information may void this application. I certify that the information on this application is true and recognize that any misrepresentation of the facts may lead to the loss of my adoption/foster privileges with Miko's Sanctuary. I authorize Miko's Sanctuary to verify all information on this application and will allow an in-home inspection any time before and after adoption/foster. Please take into consideration a companion animal can live to an age of 15-20 years or more. Please be prepared to make this commitment. By signing below, you are indicating that you have never been convicted of animal cruelty, neglect, or abandonment pursuant to the Code of Virginia § 3.2-6546 D.
*
Submit
Should be Empty: