Foster Application

How did you hear about Pawsitive Impact?

Full Name*

First NameLast Name

Age

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

Do you live in a:

Do you:

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

Household Setting

RuralSuburbanUrban

Describe your Homes Activity Level

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 or Deceased (Please include Name, Breed, Age, Altered, Sexe, UTD Vaccines, Heartworm, Living/Deceased)*

(If none type NA)

Do you have a preference in 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

Are you willing to foster a family such as a pregnant animal, mom with litter, siblings, etc?

YesNoIt depends on sizeOther

How long are you able to foster an animal(s)

Are you willing to take your foster dog to vet appointments at a convenient time for you?

YesNo

Do you drive or have access to a vehicle to bring your foster to events and appointments

YesNo

If No please explain

Are you willing and able to medicate your foster, even if it 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

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?

Vet Reference: Full Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Phone Number

Area CodePhone Number

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Phone Number

Area CodePhone Number

Reference #3: Full Name

First NameLast Name

Relation to applicant(s):

E-mail

Phone Number

Area CodePhone Number

By signing & 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 Pawsitive Impact 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 Pawsitive Impact Animal Rescue and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster animal.

I accept full responsibility for the aanimal(s) actions at all times, and release Pawsitive Impact from any liabilities or damages that may be incurred because of fostering such animal(s).

I understand the animal(s) being fostered belong solely to Pawsitive Impact and I am not able to give away, rehome, or keep the animal(s) without direct consent from Pawsitive Impact.

I understand I do not have any say in the placement of the animal(s), nor do I have authority to make any medical decisions for the animal(s) without direct consent from Pawsitive Impact.

I agree to have Pawsitive Impact complete reference call checks and conduct a home visit inspection (virtually or in person) to be able to approve my foster application.

I understand I will be responsible for getting animal(s) to vet visits, transport drop offs, or adoption events as required.

I agree I will read the Foster Handbook that will be sent after approval. I will follow this guide, and if I have issues or questions I will contact Pawsitive Impact.

I understand that if I purchase anything without approval for the animal(s) I will not be reimbursed. For reimbursements, I understand I must submit receipts & have direct approval for the purchases.

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

Date

MonthDayYear

Your name (printed)*

Signature

Please list your Veterinarians information & 3 personal references- NOT living with you.Please also inform them we will be contacting them.

Requirements & Agreements