Foster Application
Please complete the form below to start the process of becoming a foster with Miri's Haven Senior Dog Rescue. PLEASE NOTE: Primary foster must be at least 21 years old -Thorough veterinary reference checks will be done and vaccines and preventatives are required - Pictures of your home and current pets will be required.
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Can we text this number?
Please Select
Yes
No
Co-Foster name (if applicable)
First Name
Last Name
Secondary Phone Number (if applicable)
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation:
*
What Type of Home do you live in?
*
Apartment/Condo
Towhouse/ Rowhome
Single Family/ Detached Home
Other
How long have you lived at this address?:
*
Do you own your own home?
*
Yes
No
Name and phone # of landlord or property management company:
*
Does your landlord have pet restrictions? If so, what are the restrictions?
*
Are you aware of any breed restrictions or local requirements regarding allowable number of pets and required vaccines for your city/state?
Yes, there are none
Yes, there are some that may affect my ability to foster
No / I don't know
Please list all residents of the home (name and age):
*
If no children, do you plan on having children or will children be visiting the household frequently?
*
Yes
No
How many pets do you currently own?
*
Please Select
0
1
2
3
4
5
6+
List each individually, including gender, species, breed, age
*
I.E- Lamby, female dog, poodle, 15 years old
Name of Vet Office where pets are seen
*
Veterinarian Phone Number
*
Are any members of your household allergic to animals?
*
Yes
No
If yes, please explain:
*
What food are you feeding/did feed your pet?
*
Are your present pets spayed or neutered?
*
Yes
No
N/A
If no, please explain.
*
If you currently own a dog or cat, how does he/she react to new pets? Have they had another pet share their home?
If no current pets, have you owned a pet in the last five years?
Have you ever lost or rehomed a pet?
*
Yes
No
If yes, please explain:
Have you volunteered or fostered with other organizations? If so, which ones?
*
Do you have a fenced yard?
*
Yes
No
How tall is your fence?:
*
Do you have a dog door leading outside?
*
Yes
No
Do you have locks and/or latches on all your gates?
*
Yes
No
N/A
Do you have a pool or hot tub?
*
Yes
No
If yes, please explain how the dog's safety managed around the pool/hot tub?
How often will your foster pet be left alone? Give an estimate regarding the number of days/week and total hours will your new pet be left alone during the day
*
Where will your foster dog sleep?
*
Where will the dog be kept when alone?
*
Which of the following would you feel comfortable with taking on with a new foster dog
Incontience/ diapers
potty training
separation anxiety
blindess
deafness
injections
oral or topical medications
reactivity/ basic manners training
willing to learn
Other
Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?
*
Yes
No
If yes, please describe:
*
I acknowledge and consent to Miri's Haven volunteers contacting my veterinarian. Understand that we cannot process your application if consent is not given.
*
Yes
No
Please provide 2 personal references (cannot be a relative) that can testify to your responsibility and ability to care for your animals and has been to your home. This is required or your application cannot be approved.
Reference #1
*
First and Last Name & Relationship to Self
Reference # 1 Phone Number
*
Reference #2
*
First and Last Name & Relationship to Self
Reference #2 Phone Number
*
If there is anything else you think we should know, please note it here:
Signature
By signing this form you consent to a personal and veterinary reference check
Please upload drivers license or photo ID
*
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Please upload the following pictures - a picture of your current pets, the front and back of your home, perimeter fencing (if applicable), living room, dining room, family room, kitchen, bedroom(s
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How did you hear about us?
Please upload a current photo (taken within the last 30 days) of each of your current pets.
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Fostering Saves Lives!
Thank you!
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Submit Adoption Application
Submit Adoption Application
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