Date of Birth*
Employer, employer address, length of time with this employer:*
Please list the address, phone number, and place of employment for your spouse*
How did you hear about us?
What type of home do you live in?
Length of time at this address:*
Do you own your home?
Please provide your landlord's name and contact information if you are currently renting:*
Please list the name, age, and relationship of all persons in the household:
Please outline what, if any, experience you have in animal rescue. Please list which rescue(s), if any, you have worked with, the length of time, and what your involvement/responsibilities were:
Please describe your experience, if any, with this breed:
Have you ever managed a multi-dog household?
If you currently have companion animals, please list the name, breed, age, sex, and if the animal is spayed/neutered. If not spayed/neutered, please explain:*
Will you crate train your foster dog?
If your foster dog misbehaves, how will you correct him?*
Please list any unacceptable/"deal breaker" behaviors in your new foster dog:*
Where will the dog be kept?
Please explain the circumstances if your foster dog will be kept outdoors, and/or tethered/tied outdoors.
How many hours each day will your foster dog be left alone?*
Have you or your spouse ever taken an animal to an animal shelter? If yes, describe the circumstances.*
Please provide the name of your veterinarian, phone number, and hospital address*
Please use this space to list any questions, concerns, or expectations about fostering and/or what type of personality you would like in a foster dog.*
Are you willing to have a VPBR representative visit the home where the foster dog will be living?
By entering in your name and the date below, you certify that the above information is true.