Foster Care Application

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Antony Rodney Richard
5 years ago
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Foster Care Application 1000 Freedom Rd, Smithfield, NC 27577 919-437-5084 - blackdogclub@outlook.com Any field marked with an asterisk (*) denotes a required field!

1 Foster Care Application 1000 Freedom Rd, Smithfield, NC blackdogclub@outlook.com Any field marked with an asterisk (*) denotes a required field! What pet(s) are you interested in fostering? Your Information Name* Age* Street Address* City* State and ZIP Code* Address* Phone Number* Driver s License Number* Employment Information Where* How Long* Work Number* Type/Hours (Circle One)* Full Time / Part Time Student / Retired References - First Reference Name* Relationship to You* Phone Number* page 1/5

2 References - Second Reference Name Relationship to You Phone Number Family & Residence Information Please list all persons living in your residence, along with their ages.* Please indicate the residence type below:* House / Mobile Home / Apartment / Condo / Other: Do you rent or own your residence?* Rent / Own / Other: If you rent, are there any breed restrictions in place? Indicate them, if any.* If you rent, please provide the name and number of your landlord below:* If you have any other pets in your home, please list them below (include breed, gender, age, whether or not they re fixed, and if they re up-to-date on vaccines):* page 2/5

3 Simple Questionnaire 1a) Have you ever provided foster care for an animal before?* 1b) If you answered Yes to 1a, tell us how it went: 2) Please tell us any foster care limitations - if any - that you would like us to know about:* 3a) What kind of foster care are you interested in (Circle all that apply)?* Newborn / Puppy / Adolescent (4 mo.+) / Adults (8 mo.+) / Litters (with mother) / Other: 3b) What size animal would you prefer to foster (Circle all that apply)?* Small / Medium / Large / Extra-large 4) How much time are you willing to foster an animal for?* 5) Do children (other than your own) typically visit your residence?* 6) Do the animals you currently own - if any - have any temperament issues? If so, explain how so.* page 3/5

4 7) If you own other animals, will you keep them separated from your foster animal? Explain why/why not.* 8) Are you capable of fostering/training an animal that is not housebroken?* 9) Have you crate trained a dog before?* 10) Will your foster be given exercise opportunities? If yes, explain how. If no, explain why not.* 11a) Please circle any canine behaviors below that you have worked with in the past - if any:* Shy / Extremely Shy / Extremely Fearful / Over-Stimulation (Jumpy, mouthy) / Handling-Defensive / Resource Guarding / Dog Aggression / People Aggression / Predatory Aggression 11b) Of the above behaviors, which would you be most comfortable working with? Why?* Legal (Be sure to read through everything!) - I understand that the animal(s) will at all times remain the sole property of the Black Dog Club Inc.. - I agree to provide the animal(s) good loving care, including at a minimum: adequate feed, adequate water, adequate shelter that is properly cleaned, adequate space in the primary enclosure for the particular type of animal depending upon its age, size, species and weight, adequate exercise and follow SPCA regulations on transportation and veterinary care when needed to prevent suffering or disease transmission. - I understand that medicines and other supplies provided by the Black Dog Club Inc. are for use with foster care animals only, and are not to be administered to animals that are not the property of the Black Dog Club Inc.. - I understand that all veterinary care must be authorized in advance by the Black Dog Club. I agree to personally incur the cost for any treatment that has not been so authorized. - I understand and acknowledge that I do not have any right or authority to keep, adopt, transfer, or place foster animals in other homes or with other individuals without direct approval from the Black Dog Club. page 4/5

5 - I agree that every animal I provide foster care for must be physically returned to the Black Dog Club Inc. by the date set forth or at any time upon the request of the Black Dog Club Inc. I also agree to return the animal(s) immediately if I am no longer able to provide adequate care. - I agree to provide the appropriate staff members at the Black Dog Club Inc. with the necessary information and materials at any time (such as fecal samples or temperature/weight measurements) to enhance the care that I am providing to the foster animal(s). - I agree to hold the Black Dog Club Inc. harmless from any direct or consequential damages arising out of this foster care arrangement. - I acknowledge that the Black Dog Club Inc. may terminate this or any other foster care arrangement at any time in its sole discretion. - I certify that no person residing in the household where the animals will be fostered has ever been charged with or convicted of animal cruelty, neglect or abandonment. By signing your signature below, you attest that all of the above information is indeed truthful, and that you agree to the aforementioned Legal section. Signature* Date* Awesome! Thank you so much for applying! :) page 5/5

VOLUNTEER FOSTER HOME APPLICATION. Name (primary foster parent of the dog) address: Home Address City, State Zip Home Phone Cell Phone:

VOLUNTEER FOSTER HOME APPLICATION. Name (primary foster parent of the dog) address: Home Address City, State Zip Home Phone Cell Phone: TELL US ABOUT YOURSELF: Name (primary foster parent of the dog) Email address: Home Address City, State Zip Home Phone Cell Phone: Age How long in current home? Employer How long at current job? Name (co