Foster Application
Personal Information
Full name
*
First Name
Last Name
E-mail
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Home phone number
*
-
Area Code
Phone Number
Cell phone number
-
Area Code
Phone Number
Work phone number
-
Area Code
Phone Number
Age of applicant (s):
18-29
30-54
55-64
64 or above
Occupation of applicants:
Do you have experience handling animals?
*
Yes
No
Please describe:
Please describe:
Have you ever owned a pet before?
*
Yes
No
For pets previously owned, but no longer with you, please explain and provide the reason. (eg. passed of old age, re-homed, took to shelter, euthanized)
For pets previously owned, but no longer with you, please explain and provide the reason. (eg. passed of old age, re-homes, took to shelter, euthanized)
Would you say that you have experience handling dogs with medical or behavioral issues?
*
Yes
No
If yes, please give us some details.
If yes, please provide the details.
Household Dynamic
Do you have any children living in your home?
*
Yes
No
If yes, how many and how old are they?
If yes, how many and how old are they?
Do you have any other people living with you?
*
Yes
No
If yes, please explain.
If yes, please explain.
Does anyone in your home have allergies to animals? Please explain.
*
Does anyone in your home have allergies to animals? If so, please explain.
Is everyone in your household equally enthusiastic about fostering a pet? Please explain.
*
Is everyone in your household equally enthusiastic about fostering a pet? Please explain.
Are you or your spouse/roommate presently:
You
Other
Both
At home
Attending school
Working outside the home
Retired
Other
Hybrid work arrangement
How many hours during an average day will your foster dog be left alone?
How would you describe the activity level in your household?
Low
Medium
High
Describe the activity
Describe the activity.
Do you have any pets in the home at the moment?
*
Yes
No
If yes, please tell us a bit about your pets (age, breed, temperament, etc)
If yes, please tell us a bit about your pets (age, breed, temperament, etc)
Are your current pets' vaccinations up to date?
*
Yes
No
If required, are you able to supply proof of vaccinations?
*
Yes
No
If your pets are not up-to-date with their vaccinations, please let us know why.
If your pets are not up-to-date with their vaccinations, please let us know why.
Are your pets spayed or neutered?
*
Yes
No
If required, are you able to supply proof of alteration?
*
Yes
No
If your pets are not spayed/neutered, please let us know why.
If your pets are not spayed/neutered, please let us know why.
Environmental Information
What is your housing situation?
Please Select
Select one
I own my own home
I rent my home
I live with my family
If you rent, do you have permission to have pets?
Yes
No
Landlord's name
First Name
Last Name
Landlord's phone number
-
Area Code
Phone Number
What type of home?
Please Select
House
Condo/Apartment
Townhouse
Acreage
Does your residence have stairs?
Yes
No
How will your new foster be confined to the property? Please check all that may apply.
House
Kennel
Fenced Yard
Chained
Patio Area
Do you have a fenced yard?
Yes
No
What type of fence do you have?
Wood
Chain Link
Other
How high is your fence?
*
Please Select
4 feet and under
5 feet
6 feet
over 6 feet
How high is your gate?
*
Please Select
4 feet and under
5 feet
6 feet
over 6 feet
Is it possible for a dog or puppy to crawl or dig under the fence?
*
Yes
No
Is there an area in your home where your foster dog can be isolated?
Is there an area in your home where your foster dog can be isolated?
Yes
No
Please describe.
Foster Matching
Are you able to foster a dog of any age?
*
Yes
No
If not, please let us know why.
If not, please let us know why?
Are you able to foster male and female dogs?
*
Yes
No
If not, please let us know why.
If not, please let us know why.
Are you willing to foster a dog until it is adopted, as long as it takes, barring unusual circumstances?
*
Yes
No
If not, please let us know why.
If not, please let us know why.
Foster Responsibilites
Are you willing to take the time to work with a foster dog on housebreaking issues or other issues as they arise?
*
Yes
No
Do you agree to keep your foster dog leashed or in a securely fenced area at all times?
*
Yes
No
Do you agree to keep a collar and harness with an ID tag on your foster dog at all times?
*
Yes
No
Do you have reliable transportation to take a foster dog to medical appointments, training assessments and events?
*
Yes
No
Do you agree to "puppy proof" your home and remove/store/lock up items that could be damaged or ingested?
*
Yes
No
Do you understand and accept that dogs can cause damage to your flooring, furniture, vehicles and belongings by chewing, scratching and having accidents?
*
Yes
No
Do you agree to relieve and absolve hart and any of its members of any responsibility for said damages should they occur?
*
Yes
No
Would you be willing to have a hart representative do a home visit prior to fostering?
*
Yes
No
Additional Information
How did you hear about hart?
*
Friend
Social Media
Newspaper
Veternarian
Public Event
Store Display
Other
Comments
Comments.
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