Foster Application Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Best time to be contacted? * Morning Afternoon Evening Anytime Phone * (###) ### #### Email * Emergency Contact Name First Name Last Name Emergency Contact Phone (###) ### #### Co-Applicant Name First Name Last Name Please list any other adults in household * Please list names and ages of ANY children who either live with you or visit you on a regular basis (include any grandchildren or other relatives): * Names, ages, spay/neuter status, species (dog, cat, etc.), & breed of ALL pets in your household: * How does your dog(s) react to other dogs? (Friendly, submissive, growls, etc.): * Are ALL dogs in your household current on ALL recommended and/or required vaccinations? * Yes No Please list dates of last vaccination for Rabies, DHLPP, Bordetella, Lyme, etc. * Are ALL dogs in y our household spayed/neutered? * Yes No Name, address, & phone of current Veterinary Clinic and/or Veterinarian: * Have you ever had a dog diagnosed and/or treated for heartworms? * Yes No If answered yes to heartworm question, please explain. * Do you * Own Rent Type of housing: * House Apartment Townhouse Duplex Trailer Other Do you have the landlord's permission to have a dog? Yes No I own my house If you rent, please list landlord's name, address, & phone number: * Do you have a fenced yard? * Yes No What type of fencing and height of fence? * Do you allow your dog(s) to run in any unfenced areas? * Yes No If you answered yes to the above, please explain. Is anyone home during the day? * Yes No If answered no above, where will the dog be kept during the day? * If no one will be home during the day, about how many hours will the dog be left alone? * Where will the dog be kept during the day? * Where will the dog be kept during the night? * Are you familiar with crate training? * Yes No Do you have a crate available for use with your foster dog? * One can be provided. Yes No What type of dog training experience do you have? * Are you aware that your foster dog may be an adult, with an unknown history, and no prior training? * Yes No Are you aware that your foster dog may chew, dig, bark, jump, or display other undesirable behaviors while in your care? * Yes No Are you willing to take your foster dog to the vet designated by SSR for routine vaccinations and any other medical required? * SSR required medical appointments will be paid by rescue. Yes No Are you willing to work with your foster dog in areas such as basic obedience and house training? * Yes No Have you had any experience in introducing new adult dogs into your household? * Yes No Are you willing to supervise any children around your foster dog AT ALL TIMES? * Yes No Please describe the type(s) of foster dogs you are willing to have in your home, i.e. seniors, puppies, adults, male, female, special need dogs (those who may be deaf, blind, recuperating from surgery, or with medical disorders such as epilepsy, low thyroid, etc.): * Please check all interested in fostering. Seniors Puppies Adults Male Female Special Nees (deaf, blind, recuperating from surgery, or other medical conditions) How many dogs are you willing to foster at one time? (on occasion there may be a pair who need to remain together if possible) * Is there a preferred activity level for a dog you would want to foster? * Low Medium High Open Please review the below statements. * I/we affirm that no member of my household has been convicted of any animal welfare law violations such as neglect, cruelty, abandonment, etc. I agree not to give away, sell, or trade the foster dog. I will neither take the dog to a shelter nor abandon the dog. I understand that I must notify SSR, without delay, if I can no longer care for or keep the foster dog and agree to give SSR reasonable time to place my dog in another approved foster home. I affirm/I agree I disagree Foster Applicant - All of the information I have given is true and complete. * Type your name below to agree to the above statement. First Name Last Name Co-Foster Applicant - All of the information I have given is true and complete. Type your name below to agree to the above statement. First Name Last Name Comments/Notes Add any comments or notes here. Thank you! Your foster application will be reviewed by the Saving Shepherds Rescue team shortly.
