TLC Rescue: Dog Adoption Application

Henderson Home Animal Rescue

Pet Foster Application
Sumitting this application does not mean you are commiting to a dog, nor does it guarantee you will get that dog. It is simply a tool we use to help both you and us identify a good potential match for your family and lifestyle.

A successful foster depends on selecting the right dog for your household and a good understanding of the dog's needs and care requirements. Please help us with this process by answering the following questions fully & completely. THANK YOU!
Foster Applicant Information
Name of the dog you want to foster*
Foster's Name*
First & Last Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Foster’s E-mail*
Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Names and ages of all permanent residents of your home (adults/children)*
Do you currently have any pets?*

YesNo
If you currently have pets, please list them below.
Are your current pets altered?

YesNoWill be within the next 30 days, appointment has been scheduled. (We will call your vet to verify this.)
If your current pets are not altered, please explain why below.
One Personal References*
When will you be ready to foster this dog?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Is anyone in your home allergic to dogs?*

YesNo
Does anyone in your home fear dogs?*

YesNo
Do you live in an area with dog breed restrictions?*

YesNo
If yes, please describe local dog regulations and restrictions:
I/We live in a*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
Renters, have you contacted your landlord to find out if there's any restrictions on the kind or size of dog you can have?

YesNoNot yet, but I willIt's written in our lease
Approximate square footage of your home*

Less than 800 square feet800-1,000 square feet1,000-1,500 square feet1,500-2,000 square feetOver 2,000 square feet
Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
If vertical fence, what is your fence height?

2' high3' high4' high5' high6' high
Do you work outside the home?*

YesNoOne applicant is home/works from homeWe work different shifts
If you work outside the home, how many hours per day are you away?
How many hours per day will this dog be alone? Please explain.*
Have you discussed this foster with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
Based on the description in the dog's bio, do you feel pretty confident that you will be likely to foster this dog upon meeting it?*

YesNoNot sure
Upon meeting the dog, what would give you cause to not want to foster it? Please explain.*
What activity/energy level do you prefer?*

Wild and crazy is coolLeash trained daily jogging partner would be excellentMedium energy, plays a bit then hangs out with youLow energy, walks slowly on leash, a total couch potatoOther
Please check all that apply. My foster dog will...

Be kept outside most of the timeBe kept indoors most of the timeBe left outside during the work day while we are awayBe kept inside while we are awayBe crated when we are not homeHave free reign of the house when we are not homeTake frequent car rides with usBe kept on a lead line/cable in the yardBe mostly interacting with adultsBe interacting frequently with children under 8Be interacting frequently with older childrenMust be housebroken prior to adoptionWill be housetrained by usWill be walked more than one mile per day every dayWill be walked occasionallyBe trained by us without the advice of a trainerBe taking frequent car rides/trips with usBe boarded when we go on vacationStay with family when we go on vacationBe going camping with usBe going on boat trips with usBe outside with a dog house in a fenced areaBe outside chained/tethered to a dog houseBe free roaming on the farm (unfenced)Other
What would cause you to return a dog?*
Please take time to think, be honest with yourself and us when answering this question. What are you absolutely NOT willing to deal with at the time of fostering or at any time during the life of the dog?*

HousebreakingChewingJumpingPulling on leash during walksCounter surfingFear of menFear of womenFear of childrenMouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training)GrowlingBarkingRough play with my dogHigh activity levelFood/toy aggression/not willing to share with other dogsFood/toy aggression with peopleWhining/cryingCounter surfingBlindnessLimited SightDeafnessSeparation AnxietyDiabetesSpecial DietLong Term MedicationIncontinence / Leaking UrineGets stressed/carsick when riding in vehicleDoesn't know how to climb stairsCan't climb stairs due to age/arthritis/health issuesHeart conditionSkin allergiesFood allergiesYeast on coat or in earsEar mitesFleasTicksOther
What do you feel is a reasonable amount of time for a dog to adjust to life with you/your family?*
How do you plan to integrate this dog into your family?*
Do you have any additional comments, questions or concerns? Anything else you would like us to know to help match you up to a dog?*
I understand that completing this application does not guarantee I will be allowed to foster a dog, and that the application is a tool to help Henderson Home Animal Rescue determine if this dog and my family are a good fit for each other. I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved and/or removal of the foster dog from my possession. I also certify that I have never been convicted of animal cruelty or neglect.

I agree to allow a representative from Henderson Home Animal Rescue to allow a home visit prior to fostering this dog.

I understand that all dogs fostered through Henderson Home Animal Rescue will be spayed/neutered, heartworm tested, fecal tested, and vaccinated prior to fostering.

Assumption of Risk: I acknowledge that fostering involves inherent risks, including potential injuries from bites, scratches or other incidents involving the foster animal. I will release Henderson Home Animal Rescue from any legal responsibility for any damages or injury that may occur during the fostering period, including property damage or personal injury.
Please read the above, check this box, sign, and click Submit.*

I/We have read and understand all of the above.
Applicant's Signature*
Signature date*
After you submit this form, we will review the submission and contact you as soon as we can. Feel free to email us with any questions:

HendersonHomeAR@gmail.com

Henderson Home Animal Rescue reserves the right to reject any application based on information obtained during this screening process. Please understand that our primary goal is the health, happiness, and safety of our rescued dogs.

Crystal Henderson, 501-317-1726

We are Registered, 501(c)3 Non-Profit Organization Focused on Senior Dogs who have been overlooked, providing specialized care and advocating for their adoption.
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Henderson Home Animal Rescue