Foster Home Application

Full Name*

First NameLast Name

Age*

E-mail*

Phone Number*

Area CodePhone Number

Alternate Phone Number*

Area CodePhone Number

Address*

Street Address - NO PO Boxes

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

What type of home do you have?*

Do you rent or own your home?*

If renting, does your landlord allow pets?*

If yes, how many pets are allowed?*

Are there stairs in the home?*

How many people are living in the home?*

List ALL the people living in the home (INCLUDING YOURSELF). The application will not be considered without this information:*

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

Briefly explain the main reason you want to foster a Dachshund:*

Where will the dog(s) sleep at night?*

Other:*

Do you have a fenced in yard?*

Other:*

Do you have a pool?*

Do you use a Pool Service, a Garderer Servie or a Cleaning Service"*

Other:*

If you use one or more of the above, what steps do you take to keep them from letting your pets out?*

Please list pets you now have in your home. Be sure to include the following information on each pet:*

	Species/Type	Breed	Sex	Spayed/Neutered	Age	Owned since (age)
1.
2.
3.
4.
5.

Would you consider a dog that:*

	Yes	No
is 6 yrs old or older?
has been abused?
is not reliable with children?
has a physical handicap?
requires regular medication?
requires continued house training?

Would you consider a dog that:*

	Yes	No
is 6 yrs old or older?
has been abused?
is not reliable with children?
has a physical handicap?
requires regular medication?
requires continued house training?

Where will the dog be kept when you are away from home or at work?*

How many hours a day will the dog be left alone?*

Is there a limited amount of time you can foster?*

References:

Reference: Full Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Reference: Full Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Your name typed into this box constitutes your "signature" on this form:*

Note: Please review the form before submitting. All questions MUST be answered or the Application cannot be processed.