Foster Application - DOG

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1 Wisconsin Adopt A Golden Retriever (WAAGR) Foster Application - DOG So that we may be assured that the relationship between the fostered pet and you, the fostering family will be a good one, we would like you to provide us with the following information. Applicant: : address: Street Address: City: Home Phone: County: State: ZIP: have you lived at the above address? Previous address (if less than 5 ) City County: State: ZIP: Work Phone# Date of Birth: Employer: Occupation:? Co-applicant (Spouse or Significant ): First : Last : Date of Birth? Employer: Occupation:?: Please indicate where you live: apartment house condo/townhouse trailer/mobile home Do you... rent home own home

2 If you rent, do you have the landlord's permission to foster a dog? Who is the landlord? What is the landlord's phone number? 2. Please list the age preference for a Golden you might foster: Please tell us about the kind of Golden you would like to foster 3. Are you willing to foster a special medical needs Golden? 4. are you willing to foster a Golden with history of neglect or abuse and needs extra TLC? 5. are you willing to foster a Golden? 6. How many dogs would you be willing to foster at one time? yes yes no no 7. Do you have any other preferences or restrictions? 8. Why do you want to foster a Golden Retriever? Please tell us about the other family members in your household: How many people are currently living at this residence? Men: number? ages? Women: number? ages? Girls number? ages? Boys: number? ages? Please tell us the names off the other people in your household: Are the people in your home experienced with dogs? Is everyone in the household agreeable to your fostering a dog?

3 Please describe briefly why your home would be a good foster home: List animals you currently own or that are in your care/house and those you have owned in the past five, if you need more room list in comment box below: Are you currently or have you ever been a volunteer for another shelter or rescue? If yes, may we have the name and contact of this organization? What veterinary hospital do you use? Are your current pets up-to-date with their vaccinations? yes no don't know don't have pets yet Under whose name are the veterinarian hospital records? Please list your veterinarian's phone number

4 What is the name of the main pet caregiver? What best describes the main pet caregiver? (check all that apply) Retired Stay at home parent Employed Part/Full time College Student Child/Adolescent Where does your current dog stay when home alone during the day? outside in fenced area outside in dog pen outside on chain or tie-out inside in crate ; Where will your foster dog stay when home alone during the day? outside in fenced area outside in dog pen outside on chain or tie-out inside in crate ; Where do current pets sleep at night? dog house in fenced area dog house in dog pen dog house near tie-out inside in crate in my bed

5 Where will the foster dog sleep at night? dog house in fenced area dog house in dog pen dog house near tie-out inside in crate in my bed Do you have a fully or partially fenced yard? If yes, how high and what kind? Have you ever given a dog up because it didn't work out? If so, please explain the circumstances and what happened to it: How do you plan to exercise this dog? How often? Are you familiar with crate training? Would you crate train this dog if it was necessary? On an average day, how long will your dog be left without human companionship? Any additional comments regarding this application:

6 Please list 3 references (not relatives) How this reference person knows you Phone Number The undersigned applicant hereby grants WAAGR permission to confirm any information provided in this application with any appropriate third party source, including landlords, veterinarians, etc. The information obtained will be held in confidence and used only by Wisconsin Adopt A Golden Retriever, INC for purposes of this adoption application. By signing below, I certify that the information I have given is true and I realize that any misrepresentation of facts may result in my losing the privilege of fostering pets. I understand that WAGGR has the right to deny my request to foster animals for any situation that would be contrary to the organization's policies, in violation of state or local ordinances, or not in the best interest of the animal. I authorize investigation of all statements in the application. I also authorize my veterinarian to release any information requested by your organization. Signature Date: Driver's license #: Date of Birth:

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