First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County

Email*

Home Phone*

Work Phone
x

Cell Phone

Alt Email

Cell Phone Number:*

I/we understand that NorthStar makes no guarantees or statements regarding any dog's age, breed, health, or temperament. While NorthStar has made every effort to provide accurate history and assessment of all the dogs, NorthStar is not able to guarantee any dog's age, breed, medical status or history, behavior or disposition*
Choose one: Yes, I/we understand No

I/we understand that NorthsStar may require a home check before the foster contract is finalized and that NorthStart has the right to make periodic visits to the foster's premises for the purpose of checking on the health and general welfare of the animal.*
Choose one: Yes, I/we understand No

I/we understand that if for any reason I can no longer take care of the dog, he/she MUST be returned to NorthStar Pet Rescue*
Choose one: Yes, I/we understand No

I/we understand that if for any reason NorthStar deems that the dog I am fostering is not being cared for properly (e.g. repeatedly runs away, kept outside, et.c) that I/we will be required to return the dog to NorthStar*
Choose one: Yes, I/we understand No

I/we hereby release NorthStar Pet Rescue and its volunteers, directors, members, and representatives of any and all possible claims arising from injury or damage caused by any NorthStar dog to any person or property, including any expenses related thereto.*
Choose one: Yes, I/we understand No

Please enter applicants date of birth*

List ALL members of your household, INCLUDING yourself: First & Last Name, Relationship, and Age*

Does anyone in the household have PET allergies? If yes or unsure, please explain. If no, enter "NA"*

Do you Own, Rent, or Other? (If another individual actually owns the home, e.g. parent, partner then select "other")*
Choose one: Own Rent Other

In what type of home do you live?*
Choose one: Single family home Apartment Duplex Condominium Townhouse Mobile home Military housing Other - describe below

If Other, describe:

Please enter Unit or Apartment Number, if applicable:

How long have you lived at this address?*
Choose one: Less than one year 1 to 3 years Greater than 3 years

Is your name on the lease or mortgage/title?*

Is your yard fenced?*
Choose one: No fence Partially fenced Completely fenced, at least one side less than 4 ft high Completely fenced, all sides at least 4 ft high or higher Invisible (electric) fence for dog Other, describe below No yard

If other, describe:

If your yard is fenced, please describe the materials the fencing is made from

Enter: Name of complex or name of agency AND phone number. If no complex/agency enter name of Landlord and phone number*

Does your landlord have pet restrictions such as number of pets, type of pets, breed, size, etc.? If yes, describe. If no, enter "NONE"

Provide name of Owner's Association or Co-op Board AND phone number. If you do not have a home owner's association or Co-op Board enter "NA"*

Dos your association or coop have pet restrictions such as number of pets, type of pets, breed, size, etc.? If yes, describe. If no, enter "NONE"

Are ALL members of your household in agreement about fostering?*
Choose one: No I haven't told them yet Yes

Please describe why you are interested in fostering*

Who will be the primary caretaker for the dog?*

Please describe, in detail, how long the dog will be alone each day. Include commuting times to and from work. At what time does the last person leave the home in the morning? What time does the first person return home in the evenings? *

Where will the dog be kept while alone?*

How do you plan on letting the dog outside?*

Size preference for dog when full grown. Check all that apply. NOTE: we will not know how big a puppy will get as we do not know the breeds that may be mixed in the DNA.

Most of NorthStar's dogs are mixed breeds and the breeds listed are often guesses based on appearance of the dog. Please describe breed PREFERENCES or AVERSIONS. If you have NO preferences or aversions please enter "ANY BREED"*

What energy level would work with your life style? Check all that apply.

What activity level best describes your home?*
Choose one: QUIET (minimal visitors / activities) MODERATE (some visitors / activities) VERY ACTIVE (many visitors / activities)

PLEASE CHECK OFF ALL THAT APPLY. I/we are willing to do:

PLEASE CHECK ALL THAT APPLY. I am willing to foster:

Do you have an area to quarantine the dog from other animals if necessary?*

Please describe any obedience training experience you have had, or past personal experience with animal behavior or medical issues. Enter "NA" if none.*

If you would like to be able to foster puppies (under 6 months old), please describe your experience.*

List CURRENT PETS: 1) Name of pet; 2) Type; 3) Breed; 4) Current age; 5) How long have you had pet; 6) spayed/neutered?; 7) Up to date on vaccinations? If you currently do not have a pet, please enter "NONE"*

List animal hospital/clinic where your CURRENT animals receive / received care. Provide name of hospital, phone number, and last name (if different from applicant's last name) associated with pet. PHONE VET AND LET THEM KNOW WE WILL BE CALLING

List all PETS that you have had in the last 10 years, but are no longer with you. Provide: 1) Name of pet; 2) Type; 3) Breed; 4) Age when pet passed/re-homed; 5) How long did you have pet? 6) Year pet passed/re-homed? If you haven't any PAST pets, please enter "NONE"*

List animal hospital.clinic where your PAST animals received care. Provide name of hospital, phone number, and last name associated with pet (if different from applicant's last name). PHONE VET AND LET THEM KNOW WE WILL BE CALLING

Have you ever re-homed a pet or returned one to a shelter/rescue? If yes, please provide detailed circumstances including name of pet, type of pet, reason for re-homing/return, and how long did you have the pet. If you have never re-homed/returned a cat/dog, enter "NA"*

Reference #1: First & Last Name*

REF #1: Town & State*

REF#2: Relationship, check all that apply

REF#1: Phone number (please enter with dashes, e.g. 123-555-1234)*

REFERENCE #2: Name*

REF#2: Town, state*

REF#1: Relationship, check all that apply

REF#2: Phone number (please enter with dashes, e.g. 123-555-1234)*

I attest that the information provided on this application is true and accurate to the best of my knowledge. I attest that I understand that the completion and submission of this foster application does not guarantee that I will be asked to foster a NorthStar dog.*
Choose one: Yes, I attest that the information is correct No

In filling out the application electronically, entering your name below substitutes for a signature. By entering your complete and legal name, you are agreeing to abide by the requirements set in the previous questions.*
Choose one: Yes, I/we understand and agree with the above statement No

Enter your complete and legal signature*