Home Phone Number
Work Phone Number
Name of Employer
Street Address Line 2
State / Province
Postal / Zip Code
How long have you lived at this address?
Do you live in a
Name of complex or association if renting/leasing
Name and phone # of landlord or owner
Do you have a fenced yard?
What is the pet policy of where you live?
How many adults reside at this address?
Are there children in your home? If yes, how old are they?
How many hours would there be someone at home during the day?
Do you have any dogs and/or cats at home now?
What are the age/breed/sex of the animals you have at home? Are they spayed/neutered?
Please put information of each pet on a separate line
Approximate date and reason of last vet visit.
Are all pets up to date on vaccines?
Are all pets on heartworm and flea/tick preventatives?
Have you had other pets in the past 5 years?
What are the age/name/breed of the animals you have owned previously? Why are they no longer with you?
Please list each on a separate line
What Veterinary hospital/clinic do you (or did you) use?
Do you own a crate the foster dog can use?
Are you willing to purchase food for your foster dog?
Where will the foster animal(s) be when no one is home?
Where will the foster animal(s) sleep?
Why would you like to foster with CCR?
Have you fostered before? With what rescue group?
Federal and State Laws require rescue organizations perform periodic home checks (every 6 months) of all foster homes. Are you willing to allow Canine Caravan Rescue to perform a home check at a mutually agreed to time?
Please sign below if you agree that all of the information that you have given above is correct as written and to show that you authorize Canine Caravan Rescue to verify any information if needed.
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