Contact Information
Name
*
First Name
Last Name
Occupation
*
Daytime Phone
*
Mobile Phone
(if different from above)
Evening Phone
(if different from above)
Email
Address
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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
Type of Dwelling
Home
Condo
Apartment
Other
Rent or Own
Rent
Own
Residence Information
Single
*
Single
Married
Children
*
Yes
No
Any other occupants in the home?
*
yes
no
Foster Information
Name of Desired Dog
*
Experience
Do you own a pet now?
*
yes
no
Have you ever allowed an animal to breed?
*
yes
no
Does anyone in your household have allergies?
*
yes
no
Indoor Areas
Is there anybody home during the day?
*
yes
no
When will the dog be inside?
*
Do you have a doggie door?
*
yes
no
Where will the dog stay when he/she is home alone?
*
How many hours will the dog be left alone?
*
Where will the dog sleep at night?
Dog house
Garage
Inside
Which rooms are off-limits to the dog?
*
Outdoor Areas
Which outdoor areas are available to the dog?
*
Fenced Yard
Enclosed Patio
Garage
Dog House
Unfenced Common Area
Other
Type of Fence
*
Chain Link
Wood
Block Wall
Other
I have recently inspected my fences and they are in good condition
*
yes
no
Other
The fence is intact on all sides and is at least 6 feet from the ground level in all areas.
*
Yes
No
Is your yard gated?
*
Yes
No
Who has access to your yard?
*
Gardener
Pool Man
Utility Person
Neighbor
Other
Pet Care
How would you rate your level of dog-owning experience?
*
First-time Owner
Beginner
Intermediate
Advanced
Professional Trainer
Do you have a regular vet?
*
Yes
No
Preferred level of exercise with dog
*
Couch potato
Short walks
Vigorous Walks
Hike or jog regularly
Weekends at the park
When you go on vacations, who will care for the dog?
*
Friend
Kennel
Dog Sitter
Neighbor
Relative
Other
What kind of food will you feed the dog?
*
Dry dog food
Canned dog food
Other
Who will groom or bathe your dog?
*
Myself
Friend
Pet Store
Professional Groomer
How would you discipline your dog if he or she misbehaved?
*
How would you train this dog?
*
Obedience Class
Hit with newspaper
Firm verbal commands
Clicker/hand signals
Other
Do you leash your dog when out for a walk?
*
Off leash
Collar only
Corrective collar
Harness
Other
Commitment and Investment
Are you willing to live with hair on the furniture, stains on your rugs, a warm body on your bed, and an animals that might be destructive at times?
Yes
Miscellaneous
Pet History
*
Please list pets you have owned since you have been an adult and the length of ownership. If they are no longer with you, please provide an explanation.
How did you find out about us?
*
Why are you interested in adopting from a rescue?
*
Please read and initial each statement below
I understand that a home visit is required
*
yes
I understand that a home visit does not guarantee placement
*
yes
Leave No Paws Behind reserves the right to refuse fostering to any applicant for any reason.
*
yes
Please provide at least 3 references
*
Submit Application
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