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: Adele Audie Bear Chester Denver Elliot Goose Harper Harry Houdini Kayle Kelly Clarkson Lola Raven Remy Riley Sadie Tux Willow

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: