CMAR Foster Application form

Legal Name*

First NameLast Name

Age*

Birthdate*

Driver License State & Number*

E-mail*

Phone Number - Cellular*

Area CodePhone Number

Phone Number - Home

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Preferred method of contact?*

If above answer was social media please send the link to your preferred contact account.

Physical Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you:*

OwnRent/LeaseLive with ParentsOther

If renting you must include your landlords contact information including telephone number so we can verify pet allowance. Type NA if not applicable.*

Type of animal you wish to foster:*

Do you have a fenced yard?*

YesNoPartialOther

If fenced, please give details on height, material, # of gates, are gates locked or lockable? Please type NA if no fence.*

Have you or anyone in your household been convicted of an animal related crime?*

YesNoOther

If yes, or other please explain.

Have you bought, sold, given away, or surrendered an animal within the last year?*

YesNoOther

Type a question

My foster animal will:*

Other explained:

I will need CMAR to provide:*

Household Setting

RuralCity

Describe your Homes Activity Level

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Does Anyone in your Household have Allergies to Animals?*

YesNo

Are all members of your Family agreeable to Fostering an animal?*

YesNo

Please list all current pets, name, age, breed, gender? (Ex: Sam, 5yrs, Hound, Male)*

Are your current pets spayed or neutered?*

Are your current pets up to date on vaccinations?*

Please call your veternarian and give them permission to talk to Chasing Miracles Animal Rescue about your animals.

Vets Name, Address, Phone number: *

Do you have a preference in sex of foster?

MaleFemaleNo Preference

Are you willing to foster an animal of any age?

YesNo

If not, what age would you consider?

What size dog are you willing to foster? (Check all that apply)

SmallMediumLarge

Are you willing to take your foster to vet appointments at a convenient time for you?

YesNo

If No please explain

I understand that any and all vet care needed for my foster animal is to be approved by a member of CMAR. I must ask them prior to taking to any vet clinic for care, or before giving my foster animal any medication.*

Yes, I understand and agree.No, I do not understand nor agree.

Are you willing and able to medicate your foster, even if it just a monthly heartworm preventative?

YesNo

We cannot guarantee an animal to be housebroken, are you equipped to train with love and patience?

YesNo

Have you had any experience with with an emotionally or physically neglected or abused animal?

YesNo

If Yes please explain

Are you willing to use a crate for a dog if recommended?

YesNo

How many hours in a day would the foster be left alone?*

Where will your foster animal be kept while your away from home? *

I understand that any arrangements about the future home or placement of my foster animal are at 100% discretion of the Board Members of CMAR. I can suggest adopters, or refer them to CMAR to inquire about my foster animal, but have no legal right to promise them adoption of said animal, give them away, or sell them.*

Yes, I understand.No I do not understand.

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any CHASING MIRACLES ANIMAL RESCUE, animal fostered by me.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless CHASING MIRACLES ANIMAL RESCUE and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster animal. I understand that CMAR does not know any medical history about the animals that come into their care, and illness or injuries could be underlying or unknown at the time of the animal(s) entry into their care. CMAR cannot predict any animal getting sick, or having a contagious illness that could possibly be transmittable to animals in or around my household, or that my foster animal may come into contact with. I agree to not hold CMAR liable for illness to myself or my personal animals that may incur. I also agree to take full responsiblity for any illness that should occur to other animals that I have introduced my foster animal to should anything communicable arise.

I accept full responsibility for the animal(s) actions at all times, and release CHASING MIRACLES ANIMAL RESCUE, from any liabilities or damages that may be incurred because of fostering such animal(s).

I agree to have CHASING MIRACLES ANIMAL RESCUE complete reference call checks and conduct a home visit inspection to be able to approve my foster application.

I agree that if I'm unable to foster the animal(s) anymore that I will return the animal(s) to CHASING MIRACLES ANIMAL RESCUE and try to give CHASING MIRACLES ANIMAL RESCUE a 2 week period to try and find another suitable foster for the animal(s). I UNDERSTAND THAT I CANNOT KEEP, GIVE AWAY, SALE, ADOPT OUT, OR SURRENDER MY FOSTER ANIMAL TO ANYONE AND MUST RETURN IT TO CHASING MIRACLES ANIMAL RESCUE IF FOR ANY REASON I CANNOT FOSTER IT ANY LONGER!!

Your name*

Signature*

Date*

MonthDayYear