LYR Adoption/Foster Application

Which Rescue or Rescues are you interested in Fostering? (Name/'s) *

First & Second Choices

If unavailable what would your Foster Preference be? (Check all that apply)*

Check each option that you are interested in.*

Becoming a FosterFoster Short termFoster Long termBe put on a waiting list

Are you willing to work with us to correct any possible behavior issues that the rescue may have?

YesNoTo a pointYes, Short term

Do you have a preference on cat or dog?

Cats onlyNo preferenceDogs only

Name*

First NameLast Name

Date of Birth? *

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Work Phone; *

Area CodePhone Number

Contact Number*

Area CodePhone Number

Please fill out the entire application. All questions marked with a ( * ) are required and they must be answered. If they are not, the application will not submit. If any of those marked required do not pertain to you, mark (N/A) in order to move forward with the application process.

List the Names & Ages of any additional (Adult) family members or those who live in your home. *

List the Names & Ages and Relationship to you of any Children under the age of #18 who live with you or who visit your home on a regular basis. *

List the Employers, Occupations & Hours of Everyone who lives in your home? *

Do you Own or Rent your home?*

OwnRentOther

Choose which best describes your living situation.*

HouseCondoApartmentModular Home

If a Rental, does your lease permit you to have animals?*

YESNOYES/ LIMITED

If living in an apartment / condo are there any restrictions on dog ownership or Breed? (Explain)*

Do you have a yard with a fenced in yard?*

YESNO

If Yes, Please describe in detail including the Type & Height of fence and any Security measures taken to prevent animals from escaping or being harmed by predictors.*

Please be specific with your description.

IF No, Please describe how you plan to exercise the rescue ?

How many hours per day will your Rescue be left alone?*

Please describe in Detail what the Rescues living situation will be. (Please give a detailed description including hours when no one will be home.)*

Please be very Specific with your answer .

Have you had rescues previously?*

YesNo

If Yes, name, ages, breed? Describe: Where you got them, where they are now and if re homed why? *

Please be specific

Other animals living in your home? (Click all that apply)*

DogsCatsCaged AnimalsNone

Are your pets currently UTD on Vaccinations?*

YesNoSome not All

Are your pets on Heart-worm Preventative?*

YesNoNot right nowThey will be

Are your pets Spayed or Neutered?*

YesNoNot YetSome not All

List ALL family Pets/ Include the Following: (Type / Breed / Age / Dates of last Vet. appointment & Vaccinations, Heart-worm, Flea meds. & Spay/Neuter dates) *

Have any of your pets Ever displayed any Food or other aggression's toward other animals or humans?*

YesNo

If so, Please give a detailed description. (Include: Date of any bite incidents) *

List all Previous pets that you've owned in the past 5 yrs. (Include: Years owned & where they are now. *

Name & Address of Current Vet*

Name

Street Address Line

CityState

Zip Code

Phone Number

Area CodePhone Number

Fax Number

Area CodePhone Number

Name & Address of Previous Vet*

Name

Street Address Line

CityState

Zip Code

Phone Number

Area CodePhone Number

Fax Number

Area CodePhone Number

Name & Address of Groomer*

Name

Street Address Line

CityState

Zip Code

Phone Number

Area CodePhone Number

Provide 3 personal References including at least 1 person who lives with you. (Include: How they know you).*

PLEASE READ BEFORE SINGING TO ENSURE THIS IS WHAT YOUR HEART DESIRES

Questions and answers on becoming a foster parent

By signing via electronicly I agree that the information that I have provided in this application is complete and correct. I understand that any false information I have provided will invalidate this and any future applications. I further declare that I am financially and physically able to care for a rescue animal. I understand that proper food and veterinarian care may be costly, and I am able and willing to meet the needs of my rescue animal. I understand and agree to get yearly dog tags and provide Tranquility Sancturay with verifiction includilng the assigned number. I understand the requirements and grant permission for Home Checks at random, both prior to and following fostering. I submit that if a Home Check reveals falsification or misrepresentation of any facts on my part, Tranquility Sancturary reserves the right to either refuse foster or to nullify the foster and reclaim said rescue from my premises without reimbursement of the any fees. I release Tranquility Sanctuary from any liabilities I may incur from the foster process or by the rescue while in my care.

Please sign below: *

Type your full name as entered above

Date

704-629-8629

Foster Application

Adopter Personal Information

Yourself & Family

Home Environment

Rescue Animal Living Space & Care

Current & Previous Pets

Vets & Personal References

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