Res-Q-Me Dog Interest/Foster Application

The first step in the process of Adopting a Res-Q-Me dog or becoming a Foster is to complete this application. The application provides important information. With the information on your application, along with a home check we will find a pet well-suited to your lifestyle. Please provide detailed information for all questions.
To qualify for Adoption or be a Foster, you must:
•Be at least 21 years old and have a valid driver's license or state Identification Card stating your current address
•Have the knowledge and consent of a landlord, if relevant
•Be able and willing to spend the time training, working with and giving the pet affection. Please note: We reserve the right to refuse Adoption or Foster to anyone. Please be advised that we will not adopt or foster to persons who mislead or fail to provide accurate information on this application.

Today's Date

MonthDayYear

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number Home

Area CodePhone Number

Phone Number Cell

Area CodePhone Number

E-mail

Driver's License Number

Do You Rent or Own Home?

Are you planning on moving anytime soon?

If renting, may we contact your landlord?

Landlord Name

First NameLast Name

Phone Number

Area CodePhone Number

Do you have children in the home?

Please list the ages of all children in the home.

Do you have a pool?

Is your pool above ground or in-ground?

Is your pool enclosed with a fence or other structure?

Please list all other pets in your household, their breeds and ages.

Are you current dogs shots up to date?

Are your current pets spayed/neutered?

If your pets are not fixed please explain why.

Please provide Your Current Veterinarian Information

May We Contact Your Vet

Have you ever taken a pet to a shelter or given a pet away?

Explain why you have taken pet to the pound.

Explain where your new dog will sleep i.e. in a crate, separate room etc.

Explain where your new dog will be kept if it is left alone.

Explain what behavior issues would be a problem for you.

Name or Breed of Dog you are interested in Adopting or Fostering

Desired Level Of Activity with New Dog

Dog Preference Information

Do You Agree to Try Training if Your New Dogs Needs It?

Is there any additional information you would like to provide?

I agree to seek veterinary care, follow up and/or check-ups when necessary and follow the standard animal care protocol for my new pet.

I also understand and agree that I must undergo a home-check to be done by a Res-Q-Me designee prior to any pet I am looking to adopt or foster.

By signing (typing your legal name) in the space below, you are certifying that all information is correct and true and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print this for your records and retain as verification of your application.

First NameLast Name

BowWow Verification