Applicant's First Name
Applicant's Last Name
Street Address
City
State
Apartment Number (if applicable)
Zip Code
Phone Number
Please use the following format 248-555-1212
Email Address
Please enter correctly as this is the main way we will contact you
Alternate Phone Number
Date of Birth
Drivers License Number
How did you find out about us?
Petfinder
Internet Search
Family/Friend
Staff/Volunteer
Facebook/Twitter
Other
What size dog are you interested in fostering?
Small Dog (under 25 pounds) Medium Dog ( 25 to 40 pounds) Large Dog (over 45 pounds) Puppy No preference
Are you willing to bring your foster dog to adoption events at least once a month?
No Yes
Do you own other pets at the current time?
No Yes
If yes, please list their names, breeds, and ages.
Are all of your pets spayed/neutered/fixed?
Yes
No
N/A
How many pets have you owned in the last 5-10 years?
What happened to them?
Are your pets current on their vaccinations?
Yes
no
n/a
Have you ever turned your dog or cat into a shelter?
No Yes
If yes, please explain?
Veterinarian's Name
If you have never owned a pet please tell us where you would go.
Veterinarian's Address, City, State, and Zip Code
Again if you have never owned a pet please list where you would go
Veterinarian's Phone Number
Have you ever had a pet euthanized?
No Yes
If yes, please explain:
How do you feel about having pets spayed/neutered?
Agree
Disagree
Not Sure
Are you familiar with heartworm and heartworm prevention?
No Yes
If you have pets, will they adjust to a new pet in the house?
Yes
No
Unsure
N/A
Were any of your pets obedience trained?
Yes
No
N/A
Do you own or rent your home?
Own
Rent
Someone else owns the Home
Someone else rents the Home
Please select your current residence type.
House
Apartment
Condo
Townhouse
Mobile Home
Other
If you answered "other" above, please explain here:
How long have you lived at this address?
Less than one month
1-2 months
3-6 months
6-9 months
9-12 months
1-2 years
3-5 years
6-10 years
10 + years
If you rent, does your landlord and lease allow pets?
Yes
No
Unsure
N/A
Including yourself, how many people live in your household?
Please list the ages & relationship of those who live in your home.
Does anyone in your household have allergies to dogs/cats?
Yes
No
Possibly
N/A
Is there an adult home during the day?
No Yes
If no adult will be home during the day or part of the day how many hours will the dog be alone each day?
Where will your foster dog stay when left alone?
nside - Free run of the home Inside - Single room Inside - Basement or Garage Inside - Other Outside - Dog pen Outside - Fenced yard Outside - Chained Outside - Tied to run
Do you have a completely fenced-in yard? If so, what kind of fence?
Wood
Chain Link
Electric
Plastic
Iron
Other
Other (I do not have a fenced yard)
If you answered "other" above, please explain:
If you do not have a fenced yard, how will you let the animal out?
How will you handle housebreaking?
How will you handle destructive behavior?
Are you willing and able to exercise the dog on a regular basis?
Yes
No
N/A
If yes, what is the method of exercise?
Walking
Running
Dog Park / Dog Run
Other
If you answered "other" above, please explain:
Have you ever been convicted of abuse or neglect of a child or animal?
No Yes
If yes, please explain:
Are you willing to have a Hearts 'n Homes representative visit you in your home prior to fostering?
No Yes
Are you willing to follow decompression guidelines for foster dogs?
No Yes
Personal References *
Please provide names and phone number for 2 non-family references:
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal. *
Yes
No
