Host Home Application
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Over 18? Minimum age for foster in host home is 18, though family members are encouraged to participate.
Please Select
Yes
No
Do you have a valid driver's license?
Please Select
Yes
No
Employer
Occupation
Reference (personal). Please include reference name and email address:
Reference (work or volunteer related). Please include reference name and email address:
How did you hear about Helping Paws?
List names of all members of the household and the ages of any children:
Briefly describe your typical daily schedule (eg., work, school, extra-curricular activities, travel, etc.):
Please select the description that best fits your residence:
Please Select
Single Family
Townhouse
Apartment
Modular Home
Duplex
Do you rent or own?
Please Select
Rent
Own
Do you have a fenced in yard?
Please list all dogs currently living in your home (include breed, age and sex and indicate whether they are spayed/neutered):
Do any of your dogs exhibit aggression towards dogs or people?
Please Select
Yes
No
N/A
Do any of your dogs protect food or toys from dogs or people?
Please Select
Yes
No
N/A
List any other pets living in your home:
Service dogs in training who live in Host Homes are required to come to school in Eden Prairie 3 days a week (typically 9-5PM, but days and times are flexible). Are you willing and able to provide transportation to training school in Eden Prairie 3 times per week?
I can provide transportation every day that my host dog goes to school
I can provide transportation some days that my host dog goes to school
I can provide transportation one day that my host dog goes to school
I will need help with transportation every day that my host dog goes to school
Type option 4
Which days work best for your host dog to go to school during the week?
Monday
Tuesday
Wednesday
Thursday
Friday
Do you understand that Helping Paws retains ownership of all dogs placed in host homes and has the right to repossess the dog at any time or place, without notice?
Please Select
Yes
No
On average, it costs about $1,200 a year to raise a service dog. These costs include basic vet care and dog food (Helping Paws covers the costs of emergency vet care and the spay/neuter surgery as well as provides all supplies). Helping Paws can offer scholarships to those who are unable to pay. Please select which option best describes you:
I am able to cover the full amount
I am able to cover half the amount
I am able to cover just dog food (brand designated by Helping Paws)
I am not able to cover the costs and would like more information about the scholarship
Summarize your previous volunteer experience:
Special Skills or Qualifications:
Additional Comments:
I understand that entering my name below shall serve as my signature. I agree that all of the information on this form is true and accurate to the best of my knowledge, and I give permission to check the references I have listed.
Applicant Name and Date (mm/dd/yyyy):
Submit
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