Foster Home Application form

Full Name

First NameLast Name

Age

E-mail

Address

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number - Cellular

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Do you live in a:

Do you:

Describe your Homes Activity Level

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

Does Anyone in your Household have Allergies to Animals?

Please List any Pets you have (Please include Name, Breed, Age, Altered, Sex, Current on vaccines (including Rabies, Parvo/Distemper and Bordetella)

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

Are you willing to foster for a time frame of 2 weeks?

Are you willing to take your foster dog to vet appointments at a convenient time for you? This is not a requirement

Are you willing and able to medicate your foster, even if it just a monthly heartworm preventative?

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

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

If Yes please explain

Do you have a fenced yard?

If fenced, please give details on height, material.

How many hours in a day would the foster be left alone? Are you willing to crate your foster when you are not home? Crate will be provided!

If you are applying to foster Roxy…:Are you able to give her an area where other animals will not be around her? Are you aware that she is unable to walk or hold her bowels/bladder? She is not the typical foster situation, she will require extensive care with limited time left alone.

Vet Reference: Full Name

First NameLast Name

Vet Address

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number

Area CodePhone Number

E-mail

Date

MonthDayYear

Your name

E-mail

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that all needed supplies (crate, food, toys, medication, etc.) will be provided by Bully Smiles, and that I will not need to provide anything for the potential foster, other than a safe home, cleaning, and socialization.

I have inquired about the specific animal I am interested in fostering, I am aware of their current health conditions, vaccine status, and we have discussed my personal pet(s) safety against contagious diseases and parasites.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Bully Smiles Inc. 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 BSI from any liabilities or damages that may be incurred because of my neglegence.

I agree to have BSI 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 BSI and try to give BSI a 1 week period to try and find another suitable foster for the dog(s).