SECOND CHANCE SMALL DOG RESCUE - Petfinder



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FOSTER APPLICATION

We would like to thank you for your interest in helping to foster our dogs. Please answer the following questions honestly. All information will be treated as confidential. Submission of this application does not guarantee that you will be accepted as a foster home. Incomplete or misrepresentation of any facts on this application is reason for refusal.

Applicant’s Full Name: ______________________________________________ Age: ____________

Spouse/Partner’s Full Name: _________________________________________ Age: ____________

Address ____________________________________________________________________________

City/State/Zip _______________________________________________________________________

Phone: (H) [____]____________ Phone: (C) [_____]__________ Phone: (W) [____]__________, if you can be called at work.

Email Address _______________________________________________________________________

Do you check your email [ ] Daily [ ] Weekly [ ] Monthly [ ] Other

Do you ? Rent _____ Own your home _____ How long at this address ____________________

If you rent does your rental agreement permit pets? [ ] Yes [ ] No

Landlord’s name, address and phone number (required)_______________________________________

____________________________________________________________________________________

If less than 2 yrs at this address, list previous address _________________________________________

Employer ________________________________ Employer’s phone number _____________________

List all others living in your home:Name _______________________________________Age _______

_____________________________________________ Age _______

_____________________________________________ Age _______

_____________________________________________ Age _______

_____________________________________________ Age _______

Pet’s primary caretaker _____________________________________________________

Will this be your children’s first experience with a dog as part of the family? Yes _____ No _____

If necessary, are you willing to take the pet to Obedience Classes? Yes _____ No _____

Have you ever taken a dog through an Obedience Class? Yes _____ No _____

When and what type of class was this: ____________________________________________________

Home Environment

Which best describes your living situation: Home _____ Apartment _____ Mobile Home ______

Other:________________________________________________________

What type of area do you live in: City _____ Subdivision _____ Country_____ Town _____

What type of yard: No Yard _____ Small _____ Large _____ Acreage _______

Approximate size of yard: ___________________________________________

Fenced Yes _____ No _____ Type/height of fence? ______________________________

Is your fence secure and are the gates at ground level? [ ] Yes [ ] No

Will the pet have to use steps to go potty? Yes _____ No _____

Which best describes potty accommodations? Run _____ Fenced yard _____ Kennel _____

Tie Out _____ Other: ________________________________________________________________

How many hours will the pet be left alone daily? Less than 1 _____ 2-4 _____ 6-8 _____ 8+ _____

Will you be able to let the dog out during the daytime? [ ] Yes [ ] No

Where will the pet be kept while home alone? Loose in House _____ Confined in a room _____

Crate _____ Garage _____ Basement _____ Outdoors _____ Other: ______________________

Where will the pet be kept while you are home? Loose in House _____ Confined in a room _____

Crate _____ Garage _____ Basement _____ Outdoors _____ Other: ______________________

Training of Your Foster Dog

Would your foster dog be living with or exposed to any of the following on a regular basis? Check all that apply.

[ ] Other Dogs [ ] Cats [ ] Heavy Traffic [ ] Bicycles [ ] Horses

[ ] Children under 10 [ ] Squirrels, Rabbits, Birds

We strongly recommend that ALL foster dogs be crate trained, will you be able to adhere to this policy:

[ ] Yes [ ] No

When you go on vacation, where will your foster dog go? Do you have someone reliable who will care for it?

Who? __________________________________________________________________________________.

We can provide vacation care if advance notice of need is given, no less than one month prior to your departure date.

What Behaviors/Conditions Would You Have a Hard Time Dealing With in a Foster Dog? Check all that apply:

[ ] Stubbornness [ ] Fear of Humans [ ] Dominance [ ] Aggression/Biting

[ ] Not Housebroken [ ] Excessive Shedding [ ] Destructive Chewing [ ] Overly Protective

[ ] Escaping Behavior [ ] Digging Problems [ ] Submissive Traits [ ] Playing too Rough

[ ] Submissive Peeing [ ] Jumping on People [ ] Separation Anxiety [ ] Overly Energetic

[ ] Excessive Barking [ ] Excessively Needy [ ] Not Good with Other Pets

[ ] Herding other Dogs, Cats, Children [ ] Nervous or Shy Behavior

Your Other Pets/Animals

Please list all other animals that you have owned in the last five years (living or deceased).

|Name |Type of Animal |Spayed or |Age |Owned how long? |on Heartworm |Up to date on vaccinations or when |

| | |Neutered? | | |Preventive |due |

|  |  |  |  |  |  |  |

|  |  |  |  |  |  |  |

|  |  |  |  |  |  |  |

|  |  |  |  |  |  |  |

|  |  |  |  |  |  |  |

|  |  |  |  |  |  |  |

|  |  |  |  |  |  |  |

If any of the above animals you no longer have, why, what reason and how long ago? _________________ ______________________________________________________________________________________

______________________________________________________________________________________.

Do any of your current pets have a medical condition? If yes, please explain: ________________________

_______________________________________________________________________________________

How do you exercise your current dog(s)? ____________________________________________________

Please Answer the Following Questions:

1) Are you willing to allow a home visit by appointment? _______________________________________

2) Have you ever been bitten/attacked by a dog? If yes, please explain: _____________________________

________________________________________________________________________________________

3) Do you have experience with newborn/nursing moms and young animals? _____ Yes ____ No

If yes, please describe: __________________________________________________________________

4) Are you comfortable and/or knowledgeable in basic medical dog care (deworming, ear infection, administering medications, etc.) ______ Yes ____ No __________________________________

5) Are you willing to foster a special needs dog? _____ Yes ____ No

6) Do you have the means to isolate your foster from your own dogs? ____ Yes ____ No

7) Have you ever fostered with another group? ___ Yes ___ No If yes, when ____________________,

Name of organization/group? ____________________________________________________________

8) What do you hope to gain from your fostering experience with Second Chance Small Dog Rescue? _____________________________________________________________________________________

_____________________________________________________________________________________

9) Are you willing and able to transport your foster dog to the vet for medical care? ____ Yes ____ No

Please list (3) people who have known you for at least 2 years. Please list people who have knowledge of your dog care. Please list at least one non-relative.

1) Name: __________________________________ Phone Number: ______________________________

Address: _____________________________________________________________________________

Relationship to you: ________________________Email: ______________________________________

How long have you known this person? ____________________________________________________

2) Name: __________________________________ Phone Number: ______________________________

Address: _____________________________________________________________________________

Relationship to you: _______________________ Email: ______________________________________

How long have you known this person? ____________________________________________________

3) Name: __________________________________ Phone Number: ______________________________

Address: _____________________________________________________________________________

Relationship to you: _______________________ Email: ______________________________________

How long have you known this person? ____________________________________________________

Please Contact Your Vet and Let Them Know We Will Be Calling. Without Your Consent, Your Vet May Not Release Information To Us.

VETS Name: ___________________________________ Phone Number: ________________________

Address: ______________________________________________________________________________

EMERGENCY CONTACT: Please give us the name and phone number for a person to contact in case of an emergency: ___________________________________________________________________________

I hereby certify that all information submitted above is true and correct. I understand that submission of this application does not mean that I will be approved to foster and Second Chance Small Dog Rescue reserves the right to approve or deny any applicant. I authorize Second Chance Small Dog Rescue to verify any and all information in this application and to contact my personal references and vet. I agree to provide any records to Second Chance Small Dog Rescue of all foster dogs in my care. Second Chance Small Dog Rescue reserves the right to reclaim the dog/s if any information is found to be false, incomplete or for any reason at the discretion of Second Chance Small Dog Rescue.

I am willing to assume the risks involved with working with dogs that are sometimes frightened and may become aggressive. I agree to assume all risks, which may occur in working with dogs that have come into the care of Second Chance Small Dog Rescue. I understand that dogs can be destructive and a foster dog may cause damage to my property. I agree to hold harmless Second Chance Small Dog Rescue, and/or any representative of Second Chance Small Dog Rescue, for any damage or injury sustained to myself, family members, pets and/or friends as a result of having fostered this dog/s.

Signature: _______________________________________________ Date: _______________________

Signature: _______________________________________________ Date: _______________________

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