Dizzy Chihuahua Rescue FOSTER APPLICATION form
Please ensure your application is complete. Unfortunately, we do not have the resources to contact individuals to fill in any unanswered questions. If you do not wish to answer a question, please write 'NO ANSWER' in the space (do not leave it blank) Failure to answer all questions may result in your application being delayed or rejected.
Name
Date of Birth
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Month
-
Day
Year
Date
Address
Address
Address Line 2
Postcode
How long have you lived at this address
Phone number
Email
example@example.com
Occupation
Name & Address of Employer
Number of hours worked per week
0 hours / do not work
1-5 hours per week
6-10 hours per week
11-16 hours per week
17+ hours per week
If you work, how many hours do you work FROM HOME
0 hours / do not work
1-5 hours per week
6-10 hours per week
11-16 hours per week
17+ hours per week
Partners Name
Partners Date of Birth
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Month
-
Day
Year
Date
Partners Occupation
Partners Number of hours worked per week
0 hours / do not work
1-5 hours per week
6-10 hours per week
11-16 hours per week
17+ hours per week
Do you have children resident in the home
yes
no
What are their ages?
Do you have children visiting the home (grandchildren, babysitting etc)
yes
no
What are their ages?
What type of accommodation do you live in
detached
semi-detatched
terraced
flat
bungalow
Other
If other, please specify. (residential home, sheltered housing etc)
Do you rent your home
yes
no
If renting, Do you have permission from your landlord to keep a dog
yes
no
Landlords name and contact details
You will be required to provide written proof from your landlord stating pets are allowed
Do you have a secure garden with high fencing (6ft +) surrounding it
yes
no
If no, please give details
Do you have a pond
yes
no
If yes, please give details
Do you have an alarm system / CCTV
yes
no
Do you own (or have owned) a Chihuahua
yes
no
If yes, please give brief details
What other pets do you currently own (breed / gender / age)
Are all animals in the home vaccinated annually
yes
no
Are all animals in the home spayed / neutered
yes
no
Name and Address of your veterinary practice
Have you applied to foster / currently fostering for any other rescue?
yes
no
If yes, please give details
Have you had a home check by any other rescue?
yes
no
If yes, please give details
How many dogs are you able to foster at one time
Tell us about the type of dog(s) you are willing to foster (select all that apply)
male dog
female dog
unspayed or unneutered dog
puppy
age 1-5 years
6 years or older
a dog with medical issues / taking medication
Do you feel you would be able to cope with dogs with the following issues (select all that apply)
Dislike of children
Dislike of other dogs
Dislike of men
Dislike of women
Dislike of Cats
Not house trained
Scent marking
Barking
Guarding food / toys
Fear Aggression
Disobedience
Escape artist
Stealing food
medical issues
Would you be willing to travel to collect a rescue dog (travel costs covered by DCR)
yes
no
How far would you be willing to travel (miles)
Would you be willing to travel to take the dog to it's new adopted home (travel costs covered by DCR)
yes
no
How far would you be willing to travel (miles)
Would you be willing to take the dog to the vet and provide recovery care for microchipping, neutering, spaying or any other treatment it may require (travel costs covered by DCR)
yes
no
Would you be willing to feed the dog yourself and provide a healthy diet
What food would you provide
Would you be willing to cater for specialist dietary requirements
yes
no
Are you aware of what food substances are poisonous / dangerous for dogs?
where would the dog sleep
Chihuahuas are intelligent little dogs. How would you prevent them getting bored and provide mental stimulation to them?
How would you provide a safe haven for a little dog
How would you recognise stress in a dog and help the dog to settle
Please provide the name and address of someone who has known you for more than 2 years and who can provide a reference
I confirm that the above information is correct and true and give authority for Dizzy Chihuahua rescue to contact any persons named in this application to obtain any further information if required. I agree that by filling in my full name below, it will be considered an online signature and therefore legally binding for the above information.
Date
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Month
-
Day
Year
Date
Submit
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