Into the Wild Farm Foster Application

Which Rescue or Rescues are you interested in fostering? (Name/'s) *

First & Second Choices

If unavailable what would your Foster Preference be? (Check all that apply)*

Check each option that you are interested in.*

Are you willing to work with us to correct any possible behavior issues that the rescue may have?

YesNoTo a pointYes, Short term

Do you have a trainer that you would use if needed? Yes / No (If Yes / Provide Information)

Name*

First NameLast Name

Date of Birth? *

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number*

Area CodePhone Number

Please fill out the entire application. All questions marked with a ( * ) are required and they must be answered. If they are not, the application will not submit. If any of those marked required do not pertain to you, mark (N/A) in order to move forward with the application process.

List the Names & Ages of any additional (Adult) family members or those who live in your home. *

List the Names & Ages and Relationship to you of any Children under the age of #18 who live with you or who visit your home on a regular basis. *

List the Employers, Occupations & Hours of Everyone who lives in your home? *

Do you Own or Rent your home?*

OwnRentOther

Choose which best describes your living situation.*

HouseCondoApartmentModular Home

If a Rental, does your lease permit you to have animals?*

YESNOYES/ LIMITED

If living in an apartment / condo are there any restrictions on dog ownership or Breed? (Explain)*

Landlords Name;

First NameLast Name

Landlord's Phone #

Area CodePhone Number

Do you have a yard with a fenced in yard?*

YESNO

If Yes, Please describe in detail including the Type & Height of fence and any Security measures taken to prevent animals from escaping or being harmed by predictors.*

Please be specific with your description.

IF No, Please describe how you plan to exercise the rescue ?

How many hours per day will your Rescue be left alone?*

Please describe in Detail what the Rescues living situation will be. (Please give a detailed description including hours when no one will be home.)*

Please be very Specific with your answer .

Have you had rescues previously?*

YesNo

If Yes, name, ages, breed? Describe: Where you got them, where they are now and if re homed why? *

Please be specific

Other animals living in your home? (Click all that apply)*

DogsCatsCaged AnimalsNone

Are your pets currently UTD on Vaccinations?*

YesNoSome not All

Are your pets on Heart-worm Preventative?*

YesNoNot right nowThey will be

Are your pets Spayed or Neutered?*

YesNoNot YetSome not All

List ALL family Pets/ Include the Following: (Type / Breed / Age / Dates of last Vet. appointment & Vaccinations, Heart-worm, Flea meds. & Spay/Neuter dates) *

Have any of your pets ever displayed any food or other aggression's toward other animals or humans?*

YesNo

If so, please give a detailed description. (Include: Date of any bite incidents) *

List all previous pets that you've owned in the past 5 yrs. (Include: Years owned & where they are now. *

Name & Address of Current Vet*

Name

Street Address Line

CityState

Zip Code

Phone Number

Area CodePhone Number

Name & Address of Groomer*

Name

Street Address Line

CityState

Zip Code

Phone Number

Area CodePhone Number

Provide 3 personal References including at least 1 person who lives with you. (Include: How they know you).*

By signing electronically, I agree that the information I have provided in this foster application is complete and correct. I understand that any false or misleading information will invalidate this and any future applications.

I further declare that I am financially and physically able to provide temporary care for a rescue animal. I understand that proper food, veterinary care, and supplies may be costly, and I am willing and able to meet the needs of my foster animal while in my care.

I understand and agree to maintain required identification tags and/or microchip registration provided by Into the Wild Farm, including verification with the assigned number. I understand the requirements and grant permission for Home Checks at random, both prior to and during the foster period.

I submit that if a Home Check reveals falsification, misrepresentation, or failure to meet foster requirements, Into the Wild Farm reserves the right to remove the animal from my premises without reimbursement of any expenses incurred.

I acknowledge that all animals placed with me by Into the Wild Farm remain the property of the organization until formally adopted through its process. I will not transfer, rehome, or make decisions on behalf of Into the Wild Farm regarding the foster animal without express written approval.

If pledges or donations are raised on behalf of the foster animal, Into the Wild Farm will make every reasonable effort to apply available pledged funds toward the animal’s needs and provide support as resources allow. However, I understand that pledged funds are not guaranteed and assistance will depend on availability.

I release Into the Wild Farm, its Board, volunteers, and representatives from any liability I may incur from the foster process or by the rescue animal while in my care.

Please sign below: *

Type your full name as entered above

Date

Into the Wild Farm Foster Application

Foster Personal Information

Yourself & Family

Home Environment

Rescue Animal Living Space & Care

Current & Previous Pets

Vets & Personal References

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