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Hearts for Hounds Foster Application

First Name

Last Name

Age

Email

Address (City, State, Zip)

Phone Number

Do you:

If renting, please list landlord's name and phone number

Please list all people living in the household (include name, relationship, gender, and age)

Are all members of your family agreeable to fostering a dog?

Describe the activity level in your home

Do you have a fenced-in yard?

Describe the type of fence and height

Does anyone in your household have allergies to animals

Please list ALL pets you currently have residing in the home. Please include Name, Breed, Age, Altered (if not, why), and if UTD on vaccines.

Do you guve permission for Hearts for Hounds to contact your veterinarian as a reference? Please call your vet and authorize they speak to us.

Veterinarian Full Name

Veterinarian Address (City, State, Zip)

Veterinarian Phone Number

Do you have a preference in the sex of the foster?

Are you willing to foster a dog of any age?

If not, what age would you consider?

What size dog are you willing to foster? (Check all that apply)

Please list any type of dog that you are unable to foster and why (breed, coat length, sex, age, size)

Are you willing to take your foster dog to vet appointments at a convenient time for you?

If no, please explain

Are you willing and able to medicate your foster, even if it is just a monthly heartworm preventative?

Have you had any experience with an emotionally or physically neglected or abused dog?

If yes, please explain

Are you willing to use a crate for a dog if recommended?

How many hours in a day would the foster be left alone?

Describe where the pet will be kept during the day and at night

What are your plans to exercise your foster? Please list any parks nearby or trails, how many walks a day, approximate length, activities such as agility.

Please list 2 personal references who are familiar with you and your pets

By sending this electronically, 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 can result in the forfeiture of any Hearts for Hounds animal fostered by me.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Hearts for Hounds and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog.

I accept full responsibility for the dog(s) actions at all times, and release Hearts for Hounds from any liabilities or damages that may be incurred because of fostering such dog(s).

I agree to have Hearts for Hounds complete reference call checks and conduct a home visit inspection to be able to approve my foster application.

I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to Hearts for Hounds and try to give Hearts for Hounds a 2 week period to try and find another suitable foster for the dog(s).

E-Signature

Date Signed

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