Foster Application

How did you hear about us?

Facebook or other Social MediaA friendFrom an EventOther

Full Name*

First NameLast Name

Age*

Must be 25+

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Cellular*

Area CodePhone Number

Alternate Phone Number

Area CodePhone Number

Do you live in a:*

Do you:*

OwnRentLive with ParentsOther

If Renting: Does your landlord and/or property Allow Pets?

If Renting: Please provide landlord contact information.

Are there any Breed Restrictions in your living community or landlord requirements?

If yes, Please indicate breed restrictions.

Household Setting

RuralCity

Describe the Activity Level in your Home

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 in your home currently with age.*

Name of Pet, Type of Pet, Breed, Age or N/A if none

Please provide pictures of your Pets. (Not Mandetory)

Browse Files

Are All Pets in your Home Altered?*

All Dogs in the Foster Home must be Altered unless the dog is not of age or has a medical condition not allowing the dog to be altered. If no, this will be reviewed by the Rescue Director for approval.

Would you be willing to have a Team Member from Empowering Pawz call your veterinarian for a reference check? (Please authorize vet to speak with us)*

YesNoN/A no current pets

Veterinarian Name*

Clinic Name. Please put N/A If none.

Phone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Are you willing to provide your pet(s) health/vaccine records to a Team Member of Empowering Pawz?*

YesNoN/A

What timeframe are you considering fostering? Please note, if you are looking to foster 3 months past the application date, you may be required to fill out a new application.

I'm Ready NowIn the next MonthIn the next 2-3 Months

How long are you willing to foster?

Temporary (a few days to a week)Short Term (1-4 weeks)Long Term (Until the Dog(s) Are Adopted)Other

Do you have a preference in the 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)*

SmallMediumLarge

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 vet appointments?*

YesNo

If No, please explain

Are you willing and able to medicate your foster, even if it is just a 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 with an emotionally or physically neglected or abused dog?*

YesNo

If Yes please explain

How much time are you willing to give your foster dog to adjust in his/her new surroundings?*

We cannot guarantee a dog's temperament or behavior. Please describe how you would handle the foster dog if he/she is showing signs of fear/resource aggression or guarding?*

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, activities such as agility*

Please use this space to let us know anything else that you would like to add about yourself!

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 Empowering Pawz 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 Empowering Pawz 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 Empowering Pawz from any liabilities or damages that may be incurred because of fostering such dog(s).

I agree to walk (if old enough) the foster dog(s) on a leash at all times unless they are housed in a securely fenced area.

I agree to comply to any restrictions required for the Foster Dog by a Director of Empowering Pawz.

I agree to follow proper steps detailed in the foster FAQ Form regarding emergencies. In the case of emergency, the foster parent(s) must contact a Director before seeking medical treatment or seeking outside assistance.

I agree to have Empowering Pawz complete reference call checks and conduct a home visit inspection to be able to approve my foster application.

I agree that if I must leave town, I am required to let a let a Director of Empowering Pawz know if I plan to take the foster dog with. I understand that I may not transfer the dog to another home, family member, neighbor or Dog Boarding Facility unless pre-approved by a Director of Empowering Pawz.

I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to Empowering Pawz and attempt to give Empowering Pawz a 2 week period to try and find another suitable foster for the dog(s).

Click to edit

MonthDayYearHourMinutesAM/PM Option

Your name*

Co-Applicant name (if applicable)

Dog Foster Application