Foster Application for Dogs

Full Name*

First NameLast Name

Age

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

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*

RuralCityFarm

Describe the Activity Level in your Home*

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, Sex, UTD Vaccines, Living/Deceased)

Would you be willing to have us call your veterinarian for a reference check? (Please authorize veterinarian to speak with us)*

YesNo

Veterinarian Name

First NameLast Name

Phone Number

Area CodePhone Number

Do you have a preference in the 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

Please describe the type of dog you are willing to foster (Please include breed, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes*

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

YesNo

If No please explain

Are you willing and able to medicate your foster, even if it is 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 dog? Please list how many walks a day, approximate length of time and any other activities.*

I agree to keep the foster animal’s collar & ID Tag on the foster animal at all times, and to keep the foster animal on a leash or in a secure pet carrier when outside of it's foster home or fenced yard.*

YESNO

I agree to care for this foster animal in a humane and responsible manner, and to provide the foster animal with sufficient shelter, water and to feed the dog with the food supplied to me.*

YESNO

I understand that food, collar, leash, crate and other misc. items shall be supplied by Diane's Pet Rescue These items are to be returned to us once the dog has been adopted. Diane's Pet Rescue provides basic medical care as long as it is provided by our veterinarian. We appreciate any willingness to donate basics, including collar, leash, toys etc. but you will not be reimbursed.*

YESNO

I agree to notify Diane's Pet Rescue immediately in the unlikely event that the foster animal is injured or missing while in my care. I will do whatever is asked of me to ensure the safety of the foster dog.*

YESNO

I agree to be courteous, helpful, and honest to potential adopters and to cooperate in showing the foster animal and be accommodating to potential adopters.*

YESNO

I understands and agree that only designated representatives have the authority to approve and place rescued animals into foster or permanent homes, and that only authorized representatives of will conduct interviews and make adoption placement decisions. In addition, I understand that adoptions will be deemed consummated only upon execution of the Diane's Pet Rescue adoption contract, receipt of adoption fee, and final approval by an authorized representative.*

YESNO

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 a dog being 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 Diane's Pet Rescue 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 Diane's Pet Rescue from any liabilities or damages that may be incurred because of fostering such dog(s).

I understand and agrees that Diane's Pet Rescue foster animals are rescues, and that rescue animals respond to situations differently and unpredictably. I understands and agrees that Diane's Pet Rescue makes no representations or warranties express or implied, about the foster animal’s health, behavior or temperament.

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

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MonthDayYear

Your name*

Co-Applicant name (if applicable)

Full Name

First NameLast Name

Foster Application - DOGS