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 foster parent of the dog) Age Email Address Cell phone: Alt Phone: How long in current home? Employer How long at current job? Number of People in household, Total: Number of Adults Number of Children Age(s) Does anyone in the house smoke? Yes No Is everyone in the household in agreement about fostering a rescue dog? Yes No Does anyone in the household have any known animal allergies? Yes No If yes, please specify Why are you interested in fostering? If you have fostered for another organization, please provide the following: Name of the organization: Contact person at that organization: Phone number or email address of the contact person: By giving us the contact information of any organization you fostered for, you are giving Dogma Pet Rescue permission to contact this organization.
PAGE 2 Please list two personal references whom we may contact: Personal reference #1: Phone number: Email address: Your relationship: Personal reference #2: Phone number: Email address: Your relationship: TELL US ABOUT YOUR HOME: Do you: Own Rent What type of dwelling is it? House Condo Is your yard fenced in? Yes If so, what is the height Type of fencing Townhouse Apt No Are there any breed/size restrictions where you live (e.g., by apartment management, condo or homeowner s association)? Yes No If so, what is restricted? If you rent, please provide your landlord s name & contact information: Name Phone Email By providing your landlord s information, you are giving Dogma Pet Rescue permission to contact your landlord. TELL US ABOUT YOUR PETS: CURRENT PETS: Please list all cats & dogs currently in your household: CAT OR DOG NAME BREED (if dog) AGE SPAYED/NEUTERED Are your pets good with other animals? Yes No If not, explain how you will handle the introduction/and or problems that may arise?
PAGE 3 If you have cats, do you keep them indoors, outdoors or both? If you have dogs, do you keep them primarily indoors or outdoors? PREVIOUS PETS: Please list all cats & dogs you have owned during your adult life: CAT OR DOG NAME BREED (if dog) SPAYED/ NEUTERED DURATION CARED FOR/WHAT HAPPENED TO YOUR PET Please use a separate sheet of paper if you need more spaces. Have you ever turned an animal into a shelter? If yes, please explain. Please provide contact information for your veterinarian: Name Address Phone Fax By providing your veterinarian s information, you are giving Dogma Pet Rescue, Inc. permission to contact your veterinarian. You also are giving permission for your veterinarian to provide Dogma Pet Rescue, Inc. with a reference. TELL US ABOUT YOUR FOSTER DOG: Where will your new pet be kept (please be specific) During the day? At night? On average, how many hours will your foster dog be alone without a human? What days/times would you and your family (if applicable) be available for in house interview: Type(s) of dogs you would be willing and able to foster (check all that apply): Small (5 15 lbs) Puppy Medium (20 50 lbs) Adult Large (55 75 lbs) Senior Extra large (80 lbs & greater)
PAGE 4 Is there a certain breed (or mix of a certain breed) that you are interested in fostering: How many dogs are you willing and able to foster at any given time: Oftentimes, a foster dog will remain with a foster family longer than expected. Do you have a time limit on how long your foster dog can remain with you? Yes No Do you agree to hold Dogma Pet Rescue, Inc. harmless for any damages done to your home that may occur by not keeping the dog crated or supervising the dog or from possible damage due to the dog not being housebroken? Yes No Dogma Pet Rescue, Inc. often does not know the history of these dogs. Often times they do come from a history of abuse and/or neglect. Do you agree to use verbal praise without the use of physical discipline if need be while foster is in your care? Yes No Do you agree that if you need to go on vacation or are unable to care for your foster dog that the dog will only be placed in another pre approved Dogma Pet Rescue foster home? Yes No I agree to hold Dogma Pet Rescues and any directors or representatives harmless should I get bitten or injured at an adoption event or any event that Dogma Pet Rescue is participating in. (please initial) I will not participate in any criminal activity and should there be criminal charges brought up against me, I certify that such criminal activity will not occur under the name of Dogma Pet Rescue or while I am acting as an agent or volunteer under the name of Dogma Pet Rescue. (please initial) I certify that the above information is true. As I will be acting as an agent for Dogma Pet Rescue, Inc. and caring for animals that they legally own, I give Dogma Pet Rescue, Inc. permission to fully investigate the information provided as well as contact veterinarians, landlords, etc. I give permission for my veterinarian to release any information asked by a representative from Dogma Pet Rescue, Inc. Signature (for electronic transmitting purposes, your typed name will serve as a signature) Date SEE FOSTER CONTRACT & AGREEMENT ATTACHED
Revised 9/11/10 alh