COHPBR Foster Application

Today's Date

MonthDayYear

Your Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home Phone

Area CodePhone Number

E-mail

What is the Maximum amount of time you can foster a dog?

Would you be able to bring this dog to adoption events?

Do you own or rent at the above address?

Does your landlord or rental agreement have any weight and/or breed restrictions?

Landlord's Name

First NameLast Name

Landlord's Phone

Area CodePhone Number

How many adults (18 yrs & older) in household:

Who will be the primary caretaker of this dog?

Number of children in the household:

Do you have a fenced yard? Please describe

Please list ages:

What type of pets do you have now? Ages? Female / Male?

Are your current pets spayed or neutered?

Please tell us about other pets you have owned. For each pet, please include the following information: breed, age, length of ownership, how ownership ended. If the animal passed away, please include the cause of passing. If the animal was rehomed, please provide details.

Where will the dog spend most of his/her time?

How many hours per day will the dog be left alone?

Where will the dog stay when home alone?

If you have a fenced yard, please describe your fence. How high is it?

Can you work on obedience training and potty training with your foster?

Are you willing to follow COHPBR’s guidelines as to the best way to work with the dog?

Do you currently have a veterinarian? If yes, please list the practice, veterinarian's name, and phone number: