BHR Foster Application

Broken Hearts Rescue Foster Application
Fostering Guidelines:
- 18 years of age or older
- If renting - a letter stating you may foster animals and any restrictions.
- If in a housing development - covenant must say you can a have a pet or specific breed if applicable.
- Be able/willing to provide time, love and patience to/for the furkid.
- All current animals in household must be spayed/neutered unless there are medical reasons not to.
- I will not foster for other rescues while I am fostering for BHR, (it is okay to foster for more than one rescue but not at the same time, althernating is okay).
- All people living in the home must be on board with fostering the furkid.
- A home check is required.
Initial you read and understand the above guidelines.*
Completion of this application does not guarantee a foster placement. Broken Hearts Rescue (BHR) reserves the right to deny any application if we feel that fostering is not a good fit for your family or environment. Please understand that we have the furkids best interest in mind and will place the furkids in the best home suited for them. This does not necessarily mean that your home is not suitable but that there may be a better suited home for that particular furkid. If our representative determines that your situation is not the right fit for the furkid and you would like to foster another of our furkids you may, unless told otherwise. Our ultimate goal is to place each furkid in the best suited environment for them, to help them transition into a better life and be ready for a forever home. It is hard on them to be moved from home to home, so if we can place them in the best suited foster home the first time that will be one less move for them. Throughout the application please check all items that apply when there are choices.
Initial you read, understand, and agree to the above guidelines.*
Today's Date*

MonthDayYear
Your full name:*
Other Adults Name(s) in Household:*
Street Address:*
City, State, Zip*
Phone:*

Area CodePhone Number
Spouse Phone:

Area CodePhone Number
If we need to contact you, is it okay to text?

Yes, first number onlyYes, second number onlyYes, both numbersNo
E-mail:*
*Email will only be used in reference to you fostering.
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:
Does your landlord allow dogs?

YesNo
Are there any restrictions from your landlord or subdivision? Check all that apply.*

Number of petsSize or weight restrictionsBreed restrictionsNone
*If renting, a letter will be required from landlord stating pets are okay and what if any restrictions on them prior to fostering. Your application will not be processed further until that letter/email is received.
LIST ALL dogs/cats names, ages, sizes, breeds, spayed/neutered, up to date on vaccinations residing at your listed residence:
Any household members allergic to animals? Check all that apply.*

Yes - CatsYes - DogsNo
Are you gone more than 4 hours a day where the Furkid would be left alone?*

YesNo
Explain why or why not:
Where will the furkid be housed when gone? Check all that apply.*

InsideOutsideKenneledFree reign
Where will the furkid be housed when home? Check all that apply.*

InsideOutsideKenneledFree reign
Have you ever been denied fostering/adoption of a furkid from a rescue or animal organization?*

YesNo
If yes, explain:
I understand that I may be able to foster for more than one organization and am not strictly bound to Broken Hearts Rescue, but that I CANNOT have fosters from both organizations at the same time.*

YesNo
Do you understand that the furkid may not be house broken? And if they are, they may have accidents in a changing environment?*

YesNo
Are you willing to work with the furkid on house training/issues that may arise?*

YesNo
List two non-family personal references.
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship*
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship*
List ALL PEOPLE living in your household and ages:*
Fenced front yard?*

YesNo
Type of fence and height:*
Fenced back yard?*

YesNo
Type of fence and height:*
I have read the above information carefully and have filled out this application with true and correct information. I understand that the omission of information and/or failure to answer all questions and sign this application may result in the denial of this application. I further understand that if an untruth is discovered once the application is approved that BHR reserves the right to dissolve this application and I will no longer be able to foster for BHR. INITIAL:*
BHR has my permission to check the information provided in this application and further investigate if questions arise. INITIAL:*
I will not leave the foster outside while we are not home, nor keep him/her on a tie out of any type at any time. INITIAL:*
I understand that BHR uses kenneling while away from home for the safety of the furkids and agree to kennel the furkid separate from my furkids while no one is home. INITIAL:*
Supplies needed (please check all that apply):

KennelFoodDishesLeashToysBed/beddingOther
I would like to foster (Please check all that apply):*

Dogs - Large breedDogs - Small breedCats0-3 months4-6 months6-12 months1-8 years8+ yearsMaleFemale
I/We agree to indemnify and hold Broken Hearts Rescue by, from and against all claims, suits, damages, liabilities, and costs related to or in any manner connected with any furkid in their care. I/We further acknowledge understanding that the furkid is the property of Broken Hearts Rescue, and that they may place, spay/neuter, medically treat or any other actions they feel necessary. INITIAL:*
If electronically submitting this form, I understand that my typed name serves as my signature. INITIAL:*
Electronic Signature:*
How did you find out about Broken Hearts Rescue?

PetcoRescue MeFacebookOther websiteFriend/Family MemberBroken Hearts Rescue WebsiteOther
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Broken Hearts Rescue Foster Application