Dog Fostering Application

Name (required)


Address (required)

Phone Number (required)

Email (required)

Date of Birth (required)
/ /

List your current occupation, employers name/phone number and your daily work hours. (required)

List all pets currently in household
Pet 1
Breed:
Name:
Sex:  Female Male
Age:
Sterilized:  Yes No


Pet 2
Breed:
Name:
Sex:  Female Male
Age:
Sterilized:  Yes No


Pet 3
Breed:
Name:
Sex:  Female Male
Age:
Sterilized:  Yes No


Pet 4
Breed:
Name:
Sex:  Female Male
Age:
Sterilized:  Yes No


Pet 5
Breed:
Name:
Sex:  Female Male
Age:
Sterilized:  Yes No


If pet(s) are not sterilized, do you plan on doing so in the future?
 Yes No

If no, why?

Are pet(s) vaccines current?
 Yes No

Please contact your veterinarian(s) and give them permission to discuss your pets with us (CARE). We will attempt to contact your veterinarian(s) two times over the next three business days. If they are unable to discuss your pets with us on the second call, this application will be discarded.

Name of Veterinarian/Clinic
Name:
Phone number:
Address:

Do you …
Own?  Single Family Duplex Townhouse Condo

If condo, condo association phone number and email:
Phone number:
Email:

or
Rent?  Single Family Apartment Townhouse

If renting, landlords name and phone number and e-mail:
Name:
Phone number:
Email:

What is the pet policy where you live?

List any children currently living in the household or who frequently visit
 Age:
 Age:
 Age:
 Age:
 Age:

List all adults currently living in the household along with their relationship to you and date of birth:

I would like to foster:
 Adult Dog
 Young adult Dog
 Injured Dog
 Hospice Dog
 Special needs dog (lacking socialization, training or in need of medical care)

Are you willing to foster dogs with kennel cough or other respiratory infections?
 Yes No

Please list previous experience with caring for a special needs dog:

On average how many hours per day would the your dog be alone? (required)

When you are not home where will the foster dog be kept? (required)

Do you have a spare room that can be used to confine a foster dog?
 Yes No

What length of time are you willing to commit to fostering?
 1 month 2 months Until the dog is adopted

Have you ever surrendered a pet? (required)
 Yes No

If yes, why?

Do you have a fenced in backyard? (required)
 Yes No

If no, how will the dog be exercised?

Where will the foster dog sleep? (required)

Best time of day to be reached by phone

Any additional information about why you want to foster, yourself, or any other information that you would like to share.

I certify that all the information given above is accurate to the best of my ability and give CARE authorization to verify any information. I certify that the information I have given is true and correct. I understand that any misrepresentation of this application may result in my losing the privilege to foster a pet from CARE. I understand that CARE has the right to deny my request to foster a pet, and I authorize investigation of all statements in this application.

Applicant Signature:

Date: / /

Waiver of Liability
In consideration of CARE accepting my application for participation in its foster care program, I agree to release and hold harmless CARE from and against any and all loss, damage, claims, liability, costs and expenses, of any nature whatsoever, including without limitation, attorney’s fees and disbursements and do further agree to indemnify CARE for any of the foregoing asserted by any third party, including, but not limited to, other individuals residing at my home, to the extent that any of the foregoing arise from or are occasioned by my participation in CARE foster care program.

I understand there are certain risks in handling animals (may bite, scratch or injure), and I further release CARE from any liability from future injuries.

I agree to allow CARE to photograph or use for publicity or publications volunteer’s participation in the foster care program.

I agree and understand that when I care for a CARE dog, in my home, I am doing strictly as a volunteer and in the spirit of volunteerism. Thus, I will not expect to make claim for wages in return for my services.

Please enter the letters or numbers you see below.
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Applicant Signature:

Date: / /