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:

Rows	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:

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

Would you consider a dog that:

Rows	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:

Rows	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.