Foster Home Application

Full Name *

First Name Last Name

Age *

E-mail *

Phone Number *

Area Code Phone Number

Alternate Phone Number *

Area Code Phone Number

Address *

Street Address - NO PO Boxes

Street Address Line 2

City State / Province

Postal / Zip Code Country

What type of home do you have? *

Do you rent or own your home? *

If renting, does your landlord allow pets? *

If yes, how many pets are allowed? *

Are there stairs in the home? *

How many people are living in the home? *

List ALL the people living in the home (INCLUDING YOURSELF). The application will not be considered without this information: *

	Name of Individual	Relationship to you	Age of Individual
1.
2.
3.
4.
5.

Briefly explain the main reason you want to foster a Dachshund: *

Where will the dog(s) sleep at night? *

Other: *

Do you have a fenced in yard? *

Other: *

Do you have a pool? *

Do you use a Pool Service, a Garderer Servie or a Cleaning Service" *

Other: *

If you use one or more of the above, what steps do you take to keep them from letting your pets out? *

Please list pets you now have in your home. Be sure to include the following information on each pet: *

	Species/Type	Breed	Sex	Spayed/Neutered	Age	Owned since (age)
1.
2.
3.
4.
5.

Would you consider a dog that: *

	Yes	No
is 6 yrs old or older?
has been abused?
is not reliable with children?
has a physical handicap?
requires regular medication?
requires continued house training?

Would you consider a dog that: *

	Yes	No
is 6 yrs old or older?
has been abused?
is not reliable with children?
has a physical handicap?
requires regular medication?
requires continued house training?

Where will the dog be kept when you are away from home or at work? *

How many hours a day will the dog be left alone? *

Is there a limited amount of time you can foster? *

References:

Reference: Full Name *

First Name Last Name

Phone Number *

Area Code Phone Number

Reference: Full Name *

First Name Last Name

Phone Number *

Area Code Phone Number

Your name typed into this box constitutes your "signature" on this form: *

Note: Please review the form before submitting. All questions MUST be answered or the Application cannot be processed.