AdoptableJax Foster Application for Dogs

Pet's Name

Animal ID# if applicable

Shelter Rescue Coordinator E-mail if applicable

example@example.com

Full Name*

First NameLast Name

Age

Birthdate*

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home

Area CodePhone Number

Phone Number - Cellular

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Do you live in a:*

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

RuralCity

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

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

YesNo

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sexe, UTD Vaccines, Heartworm, Living/Deceased)

YesNo

Veterinarian Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

MaleFemaleNo Preference

YesNo

If not, what age would you consider?

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*

YesNo

If No please explain

YesNo

If Yes please explain

YesNo

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*

How did you hear about us? *

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

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

I agree to not take the foster dog to any vet except AdoptableJax approved vets and to receive only approved upon services. In the event a new vet is to be approved, written agreement with an approved estimate before services are rendered is required.

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

I agree if I do not return said Foster dog or if the dog is harmed in any way I may be liable to pay $5,000 to AdoptableJax.

Click to edit

MonthDayYearHourMinutesAM/PM Option

Your name*

Co-Applicant name (if applicable)

Number

Full Name

First NameLast Name

Foster Application - DOGS