Foster Application Form

How did you hear about Rustic Rover Rescue & Lodge Inc.

Full Name*

First NameLast Name

Age (must be 21 years old to foster)

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Cellular

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Do you live in a:

Do you:

OwnRentLive with ParentsOther

If Renting or living with parents: Please indicate landlord/parents contact information

Household Setting

RuralSuburbanUrban

Describe your Homes Activity Level

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

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

Does Anyone in your Household have Allergies to Animals?

YesNo

Are all members of your Family agreeable to Fostering a Dog?

YesNo

Please List any Pets you have Living or recently Deceased (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm, If Deceased within 24 months, please give reason for death*

Do you have a preference in sex of foster?

MaleFemaleNo Preference

Are you willing to foster a dog of any age?

YesNo

If not, what age would you consider?

What size dog are you willing to foster? (Check all that apply)

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 pre-approved vet appointments. vet services not pre-approved may result in non-reimbursement.

YesNo

Do you drive or have access to a vehicle to bring your foster to events, doctor appointments, meet & greets etc.

YesNo

If NO please explain

Are you willing and able to medicate your foster, example; monthly heartworm preventative?

YesNo

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

YesNo

Have you had any experience with an emotionally or physically neglected or abused dog?

YesNo

If Yes please explain

Are you willing to use a crate for a dog if recommended?

YesNo

Do you have a fenced yard?

YesNoPartial

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 you 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.

We may run a background check. Have you ever been charged and/or convicted for domestic violence and/or cruelty to animals?

YesNo

Vet Reference: Full Name*

First NameLast Name

Phone Number

Area CodePhone Number

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Phone Number

Area CodePhone Number

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Phone Number

Area CodePhone Number

Reference #3: Full Name

First NameLast Name

Relation to applicant(s):

E-mail

Phone Number

Area CodePhone 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 Rustic Rover 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 Rustic Rover 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 Rustic Rover RESCUE from any liabilities or damages that may be incurred because of fostering such dog(s).

I agree to have Rustic Rover 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 Rustic Rover RESCUE and try to give Rustic Rover RESCUE a 2 week period to try and find another suitable foster for the dog(s).

Date

MonthDayYear

Your name*

E-mail

Do you have a social media account? If so, please provide your link.*