Application Information
First Name *
Last Name *
Street Address *
City *
State *
Zip *
Cell Phone *
Home Phone
Email Address *
What are your work hours / days? *
Occupation *
Name of additional responsible adult in household.
Type of home; *
Single Family House Multi Family House Apartment Condo Live with Friends/Family/Roomates Mobile home Other (explain)
If other, please explain
Do you rent or own? *
Rent Own
If you rent, please provide your landlord name and their phone number.
Do you have your landlord's permission to have a dog (if applicable)?
No Yes
Is your yard fenced?
No Yes
How many adults in your household? *
How many and ages of children in the home. *
Are your children afraid of dogs?
No Yes
Do you have any children that visit you? *
No Yes
Are any members of your household allergic to animals? *
No Yes
Does everyone in the household agree with fostering a dog? *
No Yes
What is the activity level in your home? Select all that apply. *
Quiet, 2 or less adults/seniors, no children, applicant(s) home most of the time
Calm, Applicant(s) often home, 3 or less family members residing in the home, no young children
Moderate, Applicant(s) work typical schedule (5 days per week, home most weekends)
Active, Frequent visits by friends/family, multiple children, other pets, busy weekends
Personal References
Please provide first personal reference *
Reference phone number *
Please provide second personal reference *
2nd reference phone number *
Please provide third personal reference *
3rd reference phone number *
Veterinary Information
Please provide the name of your Veterinarian. *
Name of clinic or hospital *
City
State
Phone number *
New Dog Information
Why are you interested in fostering a dog at this time? *
Do you have any special criteria for a foster dog that would live at your residence? *
Do you currently have any other animals that live with you? *
No Yes
If yes, please tell us the following about your pets to best match our foster dog to your family
Will the foster be allowed in the house? *
No Yes
Tell us about your dog experience. Both growing up and during the recent few years. *
How many hours per day will the dog/puppy be without people home? *
Where will your dog sleep at night? *
Where/How Will Your foster Dog Spend Time Outdoors? (Select all that apply.) *
Leash Walk Only
Off Leash
Tie Out/Runner
Invisible Fence
Fenced Yard
Unfenced Yard
No Yard
Outside when people are home to supervise
Outside anytime including when family is away from the home
Other (Please explain)
If other, please explain.
How do you plan to exercise your foster dog and how often? *
Have you ever experienced dogs that did not get along? If so, how did you handle this situation? *
If your other animals do not get along with your foster dog do you have a way to separate them when you are not at home? *
No Yes
Would you be willing to foster a heartworm positive dog? *
No Yes
Would you be willing to foster a Pit Bull? *
No Yes
Would you be willing to foster a dog with medical issues? *
No Yes
Would you be willing to foster a dog with behavioral issues? *
No Yes
Is there anything else you would like us to know about your application? If yes, please explain below
How did you hear about Protectors of Animals? *
Have you adopted from POA before, if so when? *
Preferred day/time for a follow up phone call regarding your application? *
