Foster to adopt questionnaire

1
Minimum two week foster period is required to adopt. Are you willing to foster to adopt?* This field is required.
YESNO
2
A home check will be required. Are you willing to allow a volunteer to come to your home for the home check?* This field is required.
YESNO
3
In the event the dog you are interested in adopting should need vet care during the foster to adopt trial period, are you willing to take the dog to our vet located in Orange, CA?* This field is required.If no, briefly describe the reason
4
Name of the dog you are interested in adopting* This field is required.
5
Your Full Name* This field is required.
First Name
Middle Name
Last Name
Suffix
6
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Do you own or rent the residence? *
8
If you rent, do you have landlord approval to have this pet?* This field is required.
YESNO
9
Landlord name, address, phone number* This field is required.
10
Your phone number* This field is required.
Please enter a valid phone number.
11
Email* This field is required.
example@example.com
12
Social media handle links: (FB / IG / Tiktok)* This field is required.Private accounts must approve our request as it is part of the application process
Huge
Large
Normal
Small
Ok
Ok
13
Name & ages of everyone living in the home including children* This field is required.
Huge
Large
Normal
Small
Ok
Ok
14
Is everyone living in the home in agreement when it comes to adopting the above mentioned dog?* This field is required.
YESNO
15
Tell us about yourself* This field is required.Hobbies, active or quiet lifestyle, couch potatoes, etc
Huge
Large
Normal
Small
Ok
Ok
16
What is the plan to integrate a new pet into your life & home?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
17
Where will the new pet sleep?* This field is required.
18
Other pets in the home * This field is required.Names / ages / spayed/ neutered / are vaccinations current / dog friendly?
Huge
Large
Normal
Small
Ok
Ok
19
Where will this pet be kept?* This field is required.Ex: Indoor / outdoor
20
How many hours daily will the pet be left alone?* This field is required.
21
Where will the new pet be kept while no one is home?* This field is required.
22
Your vet information* This field is required.Name of vet office, phone number, address (please give permission to your vet to speak with us this is a requirement)
23
If the pet should require a bellyband or diaper while indoors, will this be an issue?* This field is required.Briefly describe answer
24
Under what circumstances would you return this dog?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
25
Why do you feel the home would be a good fit for the dog you are interested in adopting?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
26
Please describe backyard fencing * This field is required.Ex: 6 feet tall, cement blocks, secure, etc
Huge
Large
Normal
Small
Ok
Ok
27
Attach clear photos of your backyard fencing* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
28
How did you hear about Crusty Crew Rescue?* This field is required.
Should be Empty: