Foster Application for Dogs

Full Name *

First Name Last Name

Age

E-mail *

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number - Home *

Area Code Phone Number

Phone Number - Cellular *

Area Code Phone Number

Phone Number - Work

Area Code Phone Number

Do you live in a: *

Do you: *

Own Rent Live with Parents Other

If Renting: Please indicate landlord contact information

Household Setting *

Rural City Farm

Describe the Activity Level in your Home *

Busy/Noisy Moderate Comings/Goings Quiet 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?

Yes No

Are all members of your Family agreeable to Fostering a Dog? *

Yes No

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Living/Deceased)

Would you be willing to have us call your veterinarian for a reference check? (Please authorize veterinarian to speak with us) *

Yes No

Veterinarian Name

First Name Last Name

Phone Number

Area Code Phone Number

Do you have a preference in the sex of foster? *

Male Female No Preference

Are you willing to foster a dog of any age? *

Yes No

If not, what age would you consider?

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

Small Medium Large

Please describe the type of dog you are willing to foster (Please include breed, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes *

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

Yes No

If No please explain

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

Yes No

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience? *

Yes No

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

Yes No

If Yes please explain

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

Yes No

Do you have a fenced yard?

Yes No Partial

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

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

What are you plans to exercise your foster dog? Please list how many walks a day, approximate length of time and any other activities. *

I agree to keep the foster animal’s collar & ID Tag on the foster animal at all times, and to keep the foster animal on a leash or in a secure pet carrier when outside of it's foster home or fenced yard. *

YES NO

I agree to care for this foster animal in a humane and responsible manner, and to provide the foster animal with sufficient shelter, water and to feed the dog with the food supplied to me. *

YES NO

I understand that food, collar, leash, crate and other misc. items shall be supplied by Diane's' Discount Pet Supplies & Adoption Center. These items are to be returned to us once the dog has been adopted or brought back to the Adoption Center. Diane's' Discount Pet Supplies & Adoption Center provides basic medical care as long as it is provided by our veterinarian. We appreciate any willingness to donate basics, including collar, leash, toys etc. but you will not be reimbursed. *

YES NO

I agree to notify Diane's Discount Pet Supplies and Adoption Center immediately in the unlikely event that the foster animal is injured or missing while in my care. I will do whatever is asked of me to ensure the safety of the foster dog. *

YES NO

I agree to be courteous, helpful, and honest to potential adopters and to cooperate in showing the foster animal and be accommodating to potential adopters. *

YES NO

I understands and agree that only designated representatives have the authority to approve and place rescued animals into foster or permanent homes, and that only authorized representatives of will conduct interviews and make adoption placement decisions. In addition, I understand that adoptions will be deemed consummated only upon execution of the Diane's Discount Pet Supplies and Adoption Center adoption contract, receipt of adoption fee, and final approval by an authorized representative. *

YES NO

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 a dog being 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 Dianes' Discount Pet Supplies & Adoption Center and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog.

I accept full responsibility for the dog(s) actions at all times, and release Dianes' Discount Pet Supplies & Adoption Center from any liabilities or damages that may be incurred because of fostering such dog(s).

I understand and agrees that Dianes' Discount Pet Supplies & Adoption Center foster animals are rescues, and that rescue animals respond to situations differently and unpredictably. I understands and agrees that Dianes' Discount Pet Supplies & Adoption Center makes no representations or warranties express or implied, about the foster animal’s health, behavior or temperament.

I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to Dianes' Discount Pet Supplies & Adoption Center and try to give a 2 week period to try and find another suitable foster for the dog(s).

Click to edit

Month Day Year

Your name *

Co-Applicant name (if applicable)

Full Name

First Name Last Name

1486 S. Hanover St. (Rt. 100) Pottstown, PA 19465 Phone# 610-970-7500 store@ddpets.com

Foster Application - DOGS