Foster Puppy Application

Foster Puppy Raiser Application
Please Select the role(s) you are applying for:

Puppy Raiser (change a life by fostering one of our pups from 8 weeks old until 14 months (approx. 12 months)Temporary Home (provide dogs with a temporary home as we arrange and finalize next steps for their forever homes or future career paths. The commitment is typically about 2-4 weeks at a time)
About You:
Full Name*

First NameLast Name
Age
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number - Home
Format: (000) 000-0000.
Phone Number - Cellular
Format: (000) 000-0000.
Do you:*

OwnRentLive with ParentsOther
If Renting: Please indicate landlord contact information
Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*
Are you currently employed?

Full TimePart TImeStay at Home (Remote)
If you are employed, how many hours are you typically away from home?
Does Anyone in your Household have Allergies to Animals?

YesNo
About Your Experience:
Have you ever raised a puppy before?

YesNo
Have you ever had a dog?

YesNo
Are you willing and able to pay for food, veterinarian needs and supplies the puppy will need under your foster care?

YesNo
Have you participated in formal dog training classes?

YesNo
Are you willing and able to attend training classes with your foster puppy?

YesNo
About Veterinarian, Healthcare and Safety for the Foster Dog:
Do you have a veternarian?

YesNo
Veterinarian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Format: (000) 000-0000.
Are you willing and able to medicate your foster, even if it is just a monthly heartworm preventative?

YesNo
Do you have a preference in the sex of foster?

MaleFemaleNo Preference
Do you have a fenced in yard

YesNo
Are you willing to use a crate for a dog?

YesNo
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*
Agreement and References:
Have you read and understood the Foster Puppy Agreement? (see below)

YesNo
Please provide the names and contact information for two references who can speak to your ability to care for a puppy. *
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 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 Embark Foundation 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 Embark Foundation from any liabilities or damages that may be incurred because of fostering such dog(s).

I agree to have Embark Foundation 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 Embark Foundation and try to give Embark Foundation a 2 week period to try and find another suitable foster for the dog(s).
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MonthDayYear
Date
Hour MinutesAM/PM Option
Your name*
Co-Applicant name (if applicable)
Number
Full Name

First NameLast Name
Should be Empty:

Foster Puppy Raiser Application

About You:

About Your Experience:

About Veterinarian, Healthcare and Safety for the Foster Dog:

Agreement and References: