Foster Application
The Michael Movement 501(c)3 nonprofit
Your Information
Name
*
First Name
Last Name
Today's Date
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Household Questions
Do you Rent or Own your home?
*
If you rent, do you have landlord permission to foster a dog?
*
Landlord Contact information (Name and phone number)
*
Type of Housing
*
Apartment/condo
Duplex
Single Family Home
Other
If you have a yard, is it fenced? If so, what is the fence height?
*
If outside area is not contained, how to do you plan to keep the dog safe?
*
Please list all adults and ages of household occupants
*
Please list all children and ages of household occupants
*
Please list all other pets in the household
*
Foster Dog Information
Name of dog you wish to foster if known
Willing to foster the following: (Please select all that apply)
*
Separation Anxiety
High energy
Needs potty training
Needs general manners training
Shy
Human reactive
Medical needs
Dog Reactive
Resource guards
Unknown history
Needs socialization
None of the above
Senior dog
Puppy
Are you willing to allow The Michael Movement to conduct a home visit?
*
Yes
No
Daily Routine
Where will the dog sleep at night?
*
How many hours a day will the dog be left alone?
*
Where will the dog be when you are at work?
*
How do you plan to exercise your foster dog?
*
Who will be the primary caregiver?
*
Background Information
Have you fostered for an organization before?
*
Why do you want to foster with The Michael Movement?
*
Do you have a timeframe you are unavailable to foster?
*
Have you ever surrendered or rehomed a pet before? If so, why?
*
Have you ever been denied as a foster or adopter? Please explain
*
Have you had any pets with infectious diseases in the past year? If yes, what/when?
*
Who is your Primary Veterinarian?
*
Clinic Name
*
Clinic Phone number
*
Please enter a valid phone number.
Have you or anyone in your household been charged with neglect or abuse of an animal?
*
References
Please provide 3 professional/personal references. Must not reside in your residence.
Reference #1
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
How do they know you?
*
How long have they known you?
*
Reference #2
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
How do they know you?
*
How long have they known you?
*
Reference #3
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
How do they know you?
*
How long have they known you?
*
Waiver, Release of Liability and Contractual Agreement
Please select "yes" if you agree with the statements and sign below
I will allow The Michael Movement to use my photos and other forms of media for public relations and marketing purposes.
*
Please Select
Yes
No
The attest that the information included in this application is true the best of my knowledge. I understand that any falsification on this application will result in immediate denial and, if a foster animal is already placed in your home, the immediate return of the animal will be required. Submitting this application does not guarantee approval for fostering nor place a dog on hold. Approval for fostering does not give approval for adoption. I understand that The Michael Movement has the right to refuse fostering and/or adoption on any application for any reason.
*
Please Select
Yes
No
I understand The Michael Movement, its volunteers, Board of Directors, officers, agents, employees, contractors, fosters, adopters, representatives are hereby referred to as "The Michael Movement"
*
Please Select
Yes
No
I understand that there are inherent risks with housing animals. All animals are capable of biting (persons or other animals), injuring (persons or other animals), causing death and damaging property. The Michael Movement makes no claim to the health or behavior of an animal. I accept all risks and liability. I hereby indemnify and hold harmless The Michael Movement for any damages to persons or property, claims, losses, and fines. I understand that The Michael Movement is not liable for damages, financial or otherwise resulting from any action of a foster dog or interaction with The Michael Movement. This is meant to be all encompassing to the furthest extent of the law. I release The Michael Movement of all liability.
*
Please Select
Yes
No
I understand that any dog in my care will be contained at ALL TIMES. This means I will not allow my foster dog off leash in an uncontained area.
*
Please Select
Yes
No
I understand if I allow my foster dog to meet new people/pets, I accept the risk upon myself solely.
*
Please Select
Yes
No
I understand that The Michael Movement adheres to a Positive Reinforcement Training Philosophy. I will not utilize aversive tools (shock collar, prong collar, choke collar) on my foster dog. I will not physical harm or intimidate my foster dog.
*
Please Select
Yes
No
I understand I am responsible for the human care, physical and mental needs of the foster dog. I will provide food and water, exercise, shelter, medications if needed and safety.
*
Please Select
Yes
No
I understand the ownership of my foster dog is by The Michael Movement. I am not allowed to transfer, rehome, relinquish care, etc. of the foster dog without approval or consent of The Michael Movement.
*
Please Select
Yes
No
I understand the routine medical care, food and required medications will be provided by The Michael Movement. Any additional expenses, medical or otherwise incurred are responsibility of myself including unforeseen illness or injury. Any possible reimbursements must be approved by The Michael Movement.
*
Please Select
Yes
No
I agree that I am over 21 years of age and completing this application of my own will.
*
Please Select
Yes
No
By signing below, I agree to the above statements and consent for use of my electronic signature:
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