Download Report

Foster Application
CONTACT AND BACKGROUND INFORMATION Your Name: Age: Spouse Name E‐mail: Home Tel: Age: Cell Tel: ADDRESS Street: City: Prov: P/C: Your Occupation: Employer: Bus. Tel: Spouse Occupation: Employer: Bus. Tel: Do you live in a: House Townhouse Do you own or rent Condo Apartment Duplex Other IF RENTING: PLEASE INDICATE THE LANDLORD’S CONTACT INFORMATION BELOW: Name: Address: Tel: Do you have permission to foster rescue dogs? (written approval is required) How many dogs are allowed Household setting: Rural Yes No Is there a weight/size/breed restriction? Suburban Urban How long have you been at your present address? months years
Have you or any member of your family ever been convicted on any charges of Yes No animal neglect, abandonment, or cruelty? Describe your home’s activity level: Busy /noisy Moderate comings/going Quiet with occasional guests Are all members of your family agreeable to fostering a dog? Yes No Does anyone in your household have any known allergies to animals? Yes No Website: www.otowndogrescue.com E‐mail: [email protected]
Who will have primary responsibility for the care of the dog? Yes Does anyone in your household have a fear of dogs? No PLEASE COMPLETE FOR ALL PEOPLE (ADULT OR CHILD) LIVING IN THE HOUSEHOLD: Name Gender Age How did you find Ottawa Dog Rescue? Online Search (choose from the drop down list) If “Other” please explain: Please tell us why you’d like to foster an animal? Do you prefer a male or female or no preference? Male Female Are you willing to foster a dog of any age? No preference Yes No If not, what age would you consider? Please describe the type of dog you are willing to foster and include breed, coat length, personality traits, energy level etc. We want to make sure we always have the best fit between foster and dog. Will you be able to take the animal to vet appointments and allow potential adopters to visit the animal If not, please explain: Are you willing and able to medicate an animal if necessary, even if it is only monthly heartworm pills? Yes No Yes No Yes No No EXPERIENCE AND TRAINING We do not guarantee a dog to be housebroken? Are you equipped to train with love and patience? Please describe your housetraining methods Have you had any experience with an emotionally or physically neglected Yes or abused dog Website: www.otowndogrescue.com E‐mail: [email protected]
Are you willing to use a crate for a dog if recommended? Yes No Are you willing to work with an Dog Rescue volunteer regarding behavioral issues if necessary? Yes No How would you deal with unacceptable behaviors? Please describe what the dogs position in your family would be and how you would interact with it What will you do if the animal soils the floor or chews/claws the furniture? List any previous animal experience, activities, or any other information you think it would be helpful for us to know about. HISTORY Please list names and give details of all pets you have living or deceased. Name Breed Age Altered Sex UTD shots UTD Heart Worm Living or deceased IF DECEASED DUE TO ACCIDENT OR ILLNESS Please state how old it was and cause of death and if the pet was altered. If NOT altered, please explain why? Are all dogs that you currently own on heart worm prevention? Yes No Yes No Yes No Yes No If so, what brand? If your current pets altered are NOT altered (fixed) please explain why? Do you feel that a pet should be spayed/neutered? If no, why? Have you ever had to re‐home a pet? If so, why, and where did the animal go? Have you ever relinquished a pet to a shelter? If so, which one and why? Website: www.otowndogrescue.com E‐mail: [email protected]
ACCOMMODATIONS Where do your current animals stay? In the house Outside Garage Other If outside, garage or other, please explain why? Do you have a fenced yard or fenced area? Yes No Please describe height, materials etc. If fenced, number of gates and are the gates always securely latched and/or locked? How many hours in an average workday will your dog be alone? Please describe your yard: If the animal is outside for supervised activities describe what shelter would be available for it: Shed Doghouse Covered area (porch etc .) Shade trees Other (explain) WHERE WILL THE DOG BE KEPT While you’re out: Crated Loose in the house Outside At night: Crated Loose in the house Outside During the day: Crated Loose in the house Outside If you are ever away for a few days, who would take care of your dog? How will your foster dog be exercised? Under what circumstances would you need to return a foster dog? Please check all that apply. Barking Housebreaking Chewing Jumping up Shyness/other fears Shedding Digging Scratching or climbing on furniture Move Personal illness NonĞthat I can foreseeat present Other (explainďĞůŽǁ) Website: www.otowndogrescue.com E‐mail: [email protected]
REFERENCES Please list your current Veterinarian’s information and give them permission to discuss your pet’s file with a member of our team. Name: Address: Tel: Please list your previous vet’s or any other vet’s information that you have used in the past: Please list a personal reference with name, address, phone number and how related (non‐
relatives are preferable). Name: Home Tel: E‐mail: Bus. Tel: Cell Tel: ADDRESS Street: Best time to call: City: Relationship: Prov. P/C: Years they have known you: By signing below, I acknowledge that I have completely read this questionnaire and comprehend it fully. I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application or the adoption contract can result in the forfeiture of any OTTAWA DOG RESCUE animal adopted or fostered by me. I certify that the above information is correct, and I understand that the information will be verified. I understand that by signing this form, I agree to release and covenant to hold harmless OTTAWA DOG RESCUE and its members from any claims, damages, costs, or actions incurred because of the care or actions of the dog. I accept full responsibility for the dog(s) actions at all times, and release OTTAWA DOG RESCUE from any liabilities or damages that may be incurred because of fostering such dog(s). Name: Signature: Date: ADDRESS Street: Home Tel: City: Prov. P/C: Website: www.otowndogrescue.com E‐mail: [email protected]
For Office Use Only Approved Denied Screened by: Date: Reason Denied: Comments: Website: www.otowndogrescue.com E‐mail: [email protected]