Cell Phone #
E-mail Address: *
Place of Employment
Job Type Full Time Part Time Retired Unemployed Student Other N/A
Spouses Job Type Full Time Part Time Retired Unemployed Student Other N/A
What is your living situation? House – Renting House – Own Townhouse Condo Apartment Mobile Home Living with Family or Friends Other (Explain)
How long have you lived at your address?
If you rent, what is the Landlords name and phone number?
Are you planning on moving within the next year? No Yes
What age of dog are you interested in fostering?
Adult Dog (over 1 year old)
Adolescent (4 months to 1 year old)
Puppy (2 to 4 months)
Where will you keep the dog during the day?
Where will you keep the dog during the night?
Where will you keep the dog when its left alone?
How many hours a day will the dog be left alone without human companionship?
How many adults currently live in the home?
How many children currently live in the home?
What are the ages of your children?
If you have children, is this going to be their first experience with a dog? N/A Yes No
What is the activity level in your home? Energetic – Lots of Activity Average – Some Activity Quiet – Love Activity A mixture of energy levels
Does anyone in your home have allergies to pets? No Yes
If Yes, please explain:
What would you do if someone in the house became allergic to the dog?
Are you familiar with crate training? No Yes
Would you crate train a foster dog if it was necessary? Yes No
How do you intend to keep the dog on your property?
Do you have a fenced-in yard? No Yes
If you do have a fence, how tall is the fence and what type of fencing is used?
How do you intend to train a foster dog?
How do you intend to exercise a foster dog?
Do you presently have or foster any other pets? N/A No Yes
If you indicated Yes, please provide the Name, Age, Species, Breed, and Gender of each pet?
If you listed pets, are they all up-to-date on shots? Not Applicable No Yes
If you listed pets, are they all spayed or neutered? Not Applicable No Yes
If you answered No to either of the last two questions, please explain:
If you listed pets, what vet clinic do you go to?
What was the approximate date of your last vet visit?
If you do not currently own a dog, have you owned dogs in the past?
If so, what became of your dogs?
Are you aware that some shelter animals have unknown medical backgrounds? N/A No Yes
Will you be able to take your foster dog to a Pet Refuge Authorized veterinarian when necessary? No Yes
Will you be able to bring your foster dog to a Pet Refuge Dog Adoption event at least twice each month? Blank No Yes
Are you familiar with heartworm disease? No Yes
For many reasons, it can take several months to adopt out some foster dogs. Are you prepared to care for a foster dog for an extended period of time? No Yes – Up to a limit Yes – As long as it takes
Please list two character references (Name and Phone #)
How did you learn about Pet Refuge? Radio Television Newspaper Word of Mouth Facebook Twitter Internet Search Other Website Prior Experience Other
Do you have any other questions or comments?
If you confirm that the above statements are all true and factual please type your full name as an electronic signature for this application.