Golden Years Dog Sanctuary
12682 Kagel Canyon Road
Sylmar, CA 91342
818-636-1522 | goldenyearsdogsanctuary@yahoo.com
APPLICATION AND QUESTIONNAIRE FOR FOSTER OR ADOPTION
Thank you for your interest in fostering or adopting a cat/dog from Golden Years Dog Sanctuary. Please complete the following application. Return to GYDS with a copy of a valid ID and pictures of your home and yard.
PERSONAL INFORMATION
Name:
*
First Name
Last Name
Occupation:
Age:
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home phone:
Format: (000) 000-0000.
Work phone:
Format: (000) 000-0000.
Cell phone:
Format: (000) 000-0000.
Email:
*
example@example.com
How did you hear about us?
HOUSEHOLD INFORMATION
How many people are in your household?
Adults' names, relationships, and ages:
Children's ages:
Does anyone in the household have allergies to dogs?
Yes
No
Does anyone in the household have allergies to cats?
Yes
No
Do all household members agree to you fostering pets?
Yes
No
Do you live in a:
House
Apartment
Condo
Duplex
Mobile home
Do you:
Own
Rent
Lease
How long have you been at this address?
If renting/leasing, are there pet restrictions?
Yes
No
If yes, what are they?
Landlord's name:
First Name
Last Name
Landlord's phone:
Format: (000) 000-0000.
Describe your yard:
No yard
Unfenced yard
Partially fenced yard
Completely fenced yard
Height of fence:
Material:
Wood
Chain link
PVC
Brick
Other
Do you have stairs leading to your home?
Yes
No
If yes, how many?
Do you have stairs in your home?
Yes
No
If yes, how many?
Do you have a pool?
Yes
No
If yes, is it fenced from the rest of the yard?
Yes
No
Back
Next
Do you already have dogs or cats?
Yes
No
Number of dogs:
Cats:
Are your pets spayed/neutered and up to date on vaccinations?
Yes
No
Please list all pets below:
Rows
Species
Breed
Age
Sex
Altered?
Vaccinated?
1
2
3
4
5
How would you describe your level of experience with dogs? (check all that apply)
Never had a dog
Had one or more dogs as an adult
Have experience with behavioral problems
Have worked in a veterinary hospital
Have experience as / are a dog trainer
Have previous foster experience
Had dogs in my childhood
Have experience with "bully" breeds
Is your experience with (check all that apply):
Small
Medium
Large dogs
What breeds have you owned/worked with?
Where will the foster dog/cat spend most of its time?
How many hours a day will the dog/cat be left alone?
Where will the dog/cat sleep?
Where will the dog/cat be when left alone?
Are you comfortable with any of the following? (check all that apply)
Not housebroken
Separation anxiety
Giving medication
Needs additional obedience training
Excessive barking
Not good with other dogs
Not good with cats
Deaf or blind
Are you able to transport the dog/cat to and/or from the veterinarian, an adoption event, or our facility?
Yes
No
Do you understand that by fostering you agree to care for the dog/cat for an undetermined amount of time, depending on the health of the animal and/or our ability to place him/her in a permanent home?
Yes
No
Do you agree to foster the dog/cat until such time that we can either place the dog/cat or have room at our facility?
Yes
No
Back
Next
Do you understand that it is not required, but it is our goal for fosters to adopt their dogs once medical issues have been resolved and the dog is part of your home?
Yes
No
Have you ever been investigated, arrested, or convicted of animal neglect or cruelty?
Yes
No
If yes, explain:
Why do you want to foster?
Please provide the name, relationship and contact information of one reference not in your immediate family or household:
Please provide the name and contact information of your veterinarian:
Upload a copy of your valid ID
Upload a File
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Choose a file
A photo or scan of your driver’s license or other government ID.
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Photos or video of your home and yard (optional)
Upload a File
Drag and drop files here
Choose a file
Not ready yet? That’s fine. You can skip this and email them to goldenyearsdogsanctuary@yahoo.com later.
Cancel
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If accepted as a Foster or Adopter, you will be required to complete and sign a foster and/or adoption agreement.
Thank you for taking the first step to saving a life!
Signature of applicant:
*
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preview PDF
Submit
Should be Empty: