DRNC Foster Home Application

Date of Application:

MonthDayYear

How did you hear about us?

Other: (please specify)

Full Name*

First NameLast Name

Age

E-mail

Home Phone*

Area CodePhone Number

Cell Phone

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

List ALL residents in the home, including yourself:*

	Name of Individual	Email address of Individual	Age	Relationship to you
1.
2.
3.
4.
5.

Is everyone in the household willing to make a commitment to a foster dog?*

yesno

If not, why?

Does anyone in the home have allergies?*

What kind of allergies?

I live in a*

that I*

My home has*

My yard is*

Type of fence

Fence height:

If you have a fence, is it secure?

Can passersby see into your yard?*

Do you have pool, pond or jacuzzi?*

If so, is it fenced for security?

Do you have stairs inside?*

yesno

Number of stairs:

Do you have stairs outside?*

yesno

Number of stairs:

If you rent, do you have your landlord's permission to foster a dog?*

Landlord's Name and Phone:

Do you currently have other pets in the home?

yesno

If so, please list all pets in the home:

	Breed/Species	Age	Sex	Spayed or Neutered	Current on shots	Micro chipped
1.
2.
3.
4.
5.

What type of flea control do you use?

Veterinarian*

E-mail

Phone Number*

Area CodePhone Number

What will you feed the dachshund?

Have you ever owned or fostered a dachshund before? If so, give a brief description of your experience:*

What do you know about dachshund personalities?*

What do you know about dachshund breed specific problems?*

How many hours will the dachshund be left alone?*

select one:*

dayweekmonth

Where will the dachshund be left when alone?*

Will the dog have access to a doggie door while you are away?

If not, how will you handle the dog's elimination needs while you are away from home?

At what age do you think children are old enough to play with a dachshund?

Do you have children/grandchildren that visit frequently?*

If so, what are their ages?

Have they cared for pets before?

What types of pets?

What will you teach them about handling the dachshund?

What will you do if the dachshund injures the child?

What will you do if the child injures the dachshund?

Will the dachshund be allowed on the furniture? Why or why not?*

Where will the dachshund sleep during the day? at night?*

What kind of exercise will you provide for the dachshund?

How will you correct unacceptable behavior?*

How do you plan to housetrain your dachshund?*

When you travel, how will you provide for the dachshund?*

Will you consider fostering any of the following (check all that apply):

I am also interested in the following ways to volunteer for your organization (check all that apply):

Have you ever tried to adopt from us or any other rescue? If so, what was the outcome?

REFERENCES: (husband/wife or boyfriend/girlfriend or fiancee not acceptable:*

	Name of Individual	Relationship to you	Email Address	Phone Number
1.
2.
3.

I agree to act as a Foster Home for Dachshund Rescue of Northern California (DRNC). The following conditions apply to fostering DRNC dogs.

The dog(s) will remain the property of DRNC and will be turned over immediately upon request by DRNC.

RESERVATION OF RIGHTS – DRNC reserves the right to follow through on this Agreement in order to protect the welfare of the dog(s). If the Terms and Conditions of this Agreement are not upheld by the foster family, and/or if any misrepresentations have been made to DRNC by said foster family, DRNC reserves the right to terminate this Agreement and DRNC may reclaim the dog immediately, without notice, from the foster family’s home or premises. As such, any and all costs, expenses, without prior written authorization from DRNC will become the responsibility of the foster family.

The foster family may end this agreement at any time, but must give DRNC at least 5 business days to make other foster arrangements. Any non-emergency boarding costs incurred during this 5-day period are the responsibility of the foster home.

The foster family is welcome to adopt the dog at the regular adoption fee. Foster families may NOT adopt the dog to a home not approved by DRNC.

The foster family is responsible for transporting the dog to and from the vet for treatment, after authorization of treatment. However, assistance with transport can be arranged.

Any and all expenditures beyond food, approved medical treatment, and regular de- worming require written approval of DRNC. The foster family may be responsible for unapproved expenditures (see section 3).

The foster family will contact DRNC at regular intervals to report on the status of the dog. Frequent reports are encouraged.

DRNC is not responsible for injuries to people or pets, or for property loss or damage. The foster family will accept responsibility for any events that occur while fostering the dog(s).

The foster family agrees to provide accurate information to prospective adoptive families, if requested to do so, and, when possible and convenient, to allow prospective adoptive families to visit the dog(s) at the foster family's home.

All fees, donations, etc. received in connection with the adoption of the dog(s) are the sole property of and will be sent directly to DRNC.

The dog(s) will be adopted to a permanent home only under the supervision of DRNC to a family pre-approved by DRNC. Adoptive families may be contacted occasionally by the foster family to inquire about the dog(s), as long as the adoptive families are accorded respect and privacy.

For the purposes of this agreement, emergency veterinary care is considered to be a life threatening condition and/or accident where waiting to take the animal to DRNC’s designated veterinarian, during normal business hours, will endanger the animal’s life. In a true emergency, the foster family is authorized to sign for and consent to all reasonable and necessary veterinary procedures and this executed contract is proof of such authority.

Veterinary care: Any and all non emergency veterinary care will be provided by a veterinarian designated by DRNC and will be paid for by DRNC, but the foster family MUST receive prior written approval from DRNC before obtaining such services, except in emergency situations. Non emergency use of any veterinarian other than the one designated by DRNC, must have prior written approval or the foster family will be responsible for payment of the unapproved care/services.

The dog(s) will be kept in the house or in a suitable kennel facility on the grounds of the foster home and will not be allowed off-leash in an unfenced area.

ATTORNEY FEES AND COSTS - Should it become necessary for DRNC to take legal action to recover a fostered dog or otherwise enforce the provisions of this Agreement, the Undersigned Foster Home agrees to pay all costs, including court costs, and reasonable attorney's fees. The place of venue shall be Butte County, California.

I AGREE TO ALLOW agents of Dachshund Rescue of Northern California TO ENTER MY PROPERTY FOR THE PURPOSE OF REMOVING ANY FOSTER DOG FROM MY CUSTODY IF I DO NOT COMPLY WITH THE ABOVE TERMS AND CONDITIONS.

I agree that submission of this form will consitute a legal document. I understand that submission of this form does not guarantee I will be approved to foster or adopt a dog from Dachshund Resuce of Northern Calfornia.

By signing this form and clicking SUBMIT, I agree and certify that all the information provided in this application (in it's entirety) is true and correct as of the date of submission, and I understand that my application may be denied if false information is given or if it is discovered that information was ommitted on purpose or by accident.

I agree to the Foster Home Agreement and Conditons*

I agreeI disagree

Signature*

Foster Home Application

Personal Information

Residence and Family Information

Pet History

Veterinarian, Health & Behavioral Information

Foster Preferences

References

Foster Home Agreement and Conditions