Foster Application Form

How did you hear about Brick City Rescue, Inc.?

What dog are you interested in fostering?

Full Name

First NameLast Name

Facebook/Instagram Names

Age

Must be 18 or older

E-mail

example@example.com

Drive's License Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home

Area CodePhone Number

Phone Number - Cellular

Area CodePhone Number

Occupation/ Employer

Phone Number - Work

Area CodePhone Number

Do you live in a:

Do you:

If Renting: Please indicate landlord name and phone number

Describe your Homes Activity Level (this helps us find the best match for you!)

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)

Do you have a fully fenced in yard?

Does Anyone in your Household have Allergies to Animals?

If yes, please explain:

Please List any Pets you have currently in the household. (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm

Are there any frequent guests to your home (people or dogs) that your foster dog must get along with?

If yes, please explain

Have you ever surrender a pet to a shelter or given a pet away?

If yes, please explain:

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)

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

Do you drive or have access to a vehicle to bring your foster to events and appointments

If No please explain

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

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?

Have you had any experience with 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?

Where will your foster dog be kept when you are not home?

What are you plans to exercise your foster?

Please note we do not allow any of our foster dogs to go to the dog park under any circumstances.

Your foster dog MUST be on a leash at all times when in public.

Foster understands that they are not to facilitate any dog meets with their foster dog.

Vet Reference: Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Personal Reference: Full Name. This cannot be a family member.

First NameLast Name

Personal reference contact number:

Relationship to applicant:

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 BRICK CITY RESCUE 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 BRICK CITY RESCUE 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 BRICK CITY RESCUE from any liabilities or damages that may be incurred because of fostering such dog(s).

I agree that BRICK CITY RESCUE reserves the right to relinquish the dogs(s) from the home any time during the foster period.

I agree to have BRICK CITY RESCUE 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 BRICK CITY RESCUE and try to give BRICK CITY RESCUE a 2 week period to try and find another suitable foster for the dog(s).

Electronic Signature:

Date

MonthDayYear