Dog Foster Application
Dog Foster Application
Date
Time
I am interested in fostering (Please specify preferences such as size, breed, M/F, adults vs puppies, litters, bottle feeding, etc.):
Contact Info
First Name
MI
Last Name
Maiden Name
Street Address
City
State
Zip
Cell Phone
Home Phone
Email
Date of Birth (MM/DD/YYYY)
Co-Applicant Information
First Name
MI
Last Name
Maiden Name
Date of Birth (MM/DD/YYYY)
Cell Phone
Home Phone
Email
Relationship with APPLICANT
Household Information
Housing Status
Own
Rent
Length of time at current residence (years, months)
If you are renting, please list the name and phone number of your landlord
Number of children in household:
Ages:
Number of Adults in household:
Please list full legal names, including middle initial, & birthdates (MM/DD/YYYY) of additional adults in your household beyond named applicants:
If you have been at your current address for less than 2 years, please list your previous address
Street Address
City
State
Zip
Length of time at this residence (years, months)
Employment
Applicant Employer
Employed here for how many years, months
Hours worked per week
Shift
Work from Home?
Yes
No
Previous Employer (if less than one year)
Hours worked per week
Co-Applicant Employer
Employed here for how many yrs, months
Hours worked per week
Shift
Work from Home?
Yes
No
Previous Employer (if less than 1 year)
Hours worked per week
Please answer the following questions:
How many hours will the dog or puppy(s) be left alone?
Are you available to transport the dog or puppy(s) for routine and/or emergency vet care?
Yes
No
Do you have space available (e.g. a spare room) to isolate your new foster, if needed?
Yes
No
Are you willing to communicate well with the H.O.P.E. office regarding needed information such as medical and/or behavior concerns?
Yes
No
Are you willing to communicate well with the H.O.P.E. office regarding needed information to develop BIOs & pictures?
Yes
No
Are you willing to provide a safe, stimulating environment and provide adequate exercise?
Yes
No
Do you agree the dog or puppy(s) will be housed as an indoor dog and allow for supervised outdoor elimination and exercise?
Yes
No
Does anyone go home for lunch?
Yes
No
Do you have an outside run?
Yes
No
Do you have a fenced in yard?
Yes
No
Height of fence
Do you have a dog house?
Yes
No
Do you have a tie out for the dog?
Yes
No
Do you or anyone in your household have allergies to pets?
Yes
No
Where will your dog be kept during the day?
Crate
Basement
Loose in house
Loose in yard
Penned outdoors
Fenced outdoors
Tied outdoors
Other
If Other, please explain
Where will your dog be kept at night?
Crate
Basement
Loose in house
Loose in yard
Penned outdoors
Fenced outdoors
Tied outdoors
Other
If Other, please explain
Where will your dog be kept when you are gone?
Crate
Basement
Loose in house
Loose in yard
Penned outdoors
Fenced outdoors
Tied outdoors
Other
If Other, please explain
Where will the dog be kept during bad weather?
Crate
Basement
Loose in house
Loose in yard
Penned outdoors
Fenced outdoors
Tied outdoors
Other
If Other, please explain
Vet History
**Please contact your vet clinics and release your pet's records to us **
Current Pets: List all pets (canines and felines only) that you currently have. Indicate “None” if you currently have no pets. Do not include your parents' pets.
None
Dog
Cat
Name
Breed
Temperament
Age
Length of ownership
Mainly kept
Inside
Outside
Vet Clinic Used
Clinic City & Phone Number
Dog
Cat
Name
Breed
Temperament
Age
Length of ownership
Mainly kept
Inside
Outside
Vet Clinic Used
Clinic City & Phone Number
Dog
Cat
Name
Breed
Temperament
Age
Length of ownership
Mainly kept
Inside
Outside
Vet Clinic Used
Clinic City & Phone Number
Dog
Cat
Name
Breed
Temperament
Age
Length of ownership
Mainly kept
Inside
Outside
Vet Clinic Used
Clinic City & Phone Number
Please list any other current pets
Please read and sign
I certify that all information I have given on this application is true. I understand that any false information, unanswered questions or omitted information may result in rejection.
I hereby give my authorization to release of the veterinarian / clinic records for all my pets (past and present), including but not limited to: examinations, vaccine history, tests, surgeries, clinics notes, etc. to H.O.P.E. Safehouse, Inc.
Signature (digital)
Date
Co-Applicant Signature (digital)
Date