First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County

Email*

Home Phone*

Work Phone
x

Cell Phone*

Alt Email

Text/Pager Email

Do you check Facebook (social media) every day? The CISR group communicates on Facebook, and it would be important that you join in those conversations.*

Please tell us where you or your spouse are employed. *

Do you (and/or) your spouse work from home or go into an office? Please explain fully...*

How much time will the animal spend alone during the day*

Are you able to transport your Foster Dog back and forth to the CISR Vet in Bloomington, Illinois?*

Why are you interested in fostering a dog at this time?*

Have you ever owned *this* breed of dog before?*

Shelties and Collies can be VERY shy and skittish. They will panic and run away at strange noises or strange people. You must be extra cautious with a Sheltie, that they never get loose, or are able to slip out a door that gets left open. Once on the run, and in panic mode, they will not come to anyone, even an owner. You are aware of this and will take precautions to prevent this.* Please explain to us what precautions you will take.*

Are you aware of *this breeds* needs and habits? *

Do you own or rent your home*
Choose one: Rent Own

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Who lives in your home? Ages and relationship?*

How often to you have children under age 10 in your home?*

What is the speed limit of the road on which you live

Please check all that apply to the area you live in.

Is your yard fenced so that even a small animal could not escape?*

What type of fencing do you have? Height, material, etc.*

If your fence does not surround your entire back yard, please explain the space your fence covers

Approximately how many square feet does your fence enclose?

Do you have a Doggie Door?

Does a door from inside your home open directly into the fenced yard? *If no, please describe the setup*

The fence condition? Secure? Good condition? Reaches all the way to the ground? No holes or gaps

Please list all of your CURRENT Pets. Please use this format.
Name / Breed / Age / Weight / Fixed? / Microchipped? / Date acquired? /

Veterinarian's Name and Phone Number*

Do you have the time to work with a foster dog as far as house training, behavior training....etc?*

Please tell us if you are able to provide the following: Crate? Brushes? Food? Flea and Tick medication?*

Are you aware that some Rescue dogs can be extremely skittish, shy, and withdrawn? They may or may not be housetrained. They may get into the garbage...etc etc Are you ok with this, and willing to help train them?*

Do you have a size preference?*

Do you want to limit your foster dog to a certain age range?

Do you have a sex preference?*

Are you fostering a dog with the intention of adopting?*

ALL OF THE ANSWERS I HAVE GIVEN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT IF ANY OF THE ANSWERS GIVEN ARE FOUND TO BE NOT TRUE AND CORRECT, AT ANY TIME, THE ADOPTION CONTRACT WILL BE NULL AND VOID, AND IF AN ADOPTION HAS OCCURRED, I WILL IMMEDIATELY RETURN THE SHELTIE TO CENTRAL ILLINOIS SHELTIE RESCUE. (Your electronic signature here is accepted as your full written signature.)