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
Foster Dog Name Choose an animal: Amberlynn Audrey Hepburn Bandit (KP) BJ Blondie Carmelo (VP) Catana Chester Christmas Cruz (KP) Delta (KP) Hawkeye Kelly Clarkson Loretta (KP) Macgregor Moe (KP) Nicky Ohana Patches (VP) Peaches Reese Rio Rollo (VP) Sadie Serge (KP) Skittles (VP) Starburst (VP) Toffee (VP) Tootsie Pop (VP) Valentine Verona (KP)
Male:
Female:
Breed:
Microchip Registration #
How many fosters are you willing to take in at one time? Choose all that apply: 1 2 3 4
What size of pet are you willing to foster? Choose all that apply: small medium large Xlarge
Are you willing to travel and/or open your home for potential adopters to visit the dog?
Do you currently have any animals?
Please tell us about them (if applicable)
Are your pets spayed or neutered?
Current on Heartworm?
Up to date on vaccines?
Veterinarian's Name and Phone Number*
How do you plan to potty train the animal?*
What would you do if your dog develops problem such as digging:
Barking
Chewing
Will the animal be kept inside or outside* Choose one: Inside Only Outside Only Inside and Outside
Where will the animal be kept when you are home?*
Where will the animal sleep?*
Where will the animal be kept when you are not home?*
How many times will you walk the animal per day?*
Is your yard fenced* Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced
What is the height of the fence*
What type of fence Choose one: Privacy Chain Link Invisible
What is the name and phone number of the veterinary office you have used within the past 3 years? If none, state N/A. *
Place of Work
Employer's Name
Employer's Phone Number
How long have you been at your current employment?*
1
Do you rent or own your home?* Choose one: Rent Own
If you rent, please enter your landlord's name and phone number. If no, state N/A.*
If you rent, have you received the approval of your landlord to have an animal? If you own your home, state yes.* Choose one: Yes No
In what type of home do you live?* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
Do you have a Homeowners Association or Condo Owners Association?
If you checked yes to Homeowners Association or Condo Association, please provide name and contact ph #. *
List at least one reference (who is not a family member)*
In case of a temporary emergency, who would care for the animal?*
Foster’s Name (print):
List all people and their ages residing in the household. *
This is a legally binding contract. I agree that all statements I have made on this form are true. If it is found that any statements I have made on this form are not true, the fostered animal can be confiscated. EVERGLADES ANGELS DOG RESCUE™ HAS THE RIGHT TO DENY ANY FOSTER APPLICATION
Foster's Signature:
Date: