CRGI Foster Home Application

Please direct any questions to foster@collierescue.org

Full Name *

First Name Last Name

Age

E-mail *

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number - Home

Area Code Phone Number

Phone Number - Mobile

Area Code Phone Number

Phone Number - Work

Area Code Phone Number

What is the best way to reach you?

Home Work Cell Email Text Facebook

Do you use Facebook Messenger?

Yes No

Do you live in a:

Do you:

Own Rent Live with Parents Other

Please indicate landlord contact information

Household Setting

Rural Suburban Urban

Describe your Homes Activity Level

Busy/Noisy Moderate Comings/Goings Quiet with Occasional Guests

Select the types of flooring in your home

Carpet Wood Tike Concrete Vinyl

Will the collie need to use stairs in your home?

Yes No

Describe the stairs the collie will need to use

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

Does Anyone in your Household have Allergies to Animals?

Yes No

Are all members of your Family agreeable to Fostering a Dog?

Yes No

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm, Living/Deceased) *

Do you have a preference in sex of foster?

Male Female No Preference

Please describe the type of dog you are willing to foster (Please include coat length, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes.

Are you willing to foster a Collie mixed breed?

Yes No

Are you willing to foster a puppy (under 1 year)?

Yes No

Are you willing to foster a senior (over 7 years)?

Yes No

Are you willing to take your foster dog to vet appointments?

Yes No

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

Yes No

Please give details on your transportation method

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

Yes No

We do not always know what circumstances your foster dog came from. They may have accidents in the home or chew household items. Are you willing to help your foster learn good house manners with love and patience while in your home?

Yes No

ALL animals need some time to adjust to their new surrounding; especially when other animals are involved. Are you prepared to devote extra time and/or training in the beginning?

Yes No

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

Yes No

Please explain

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

Yes No

Do you have experience with crate training?

Yes No

Describe your crate training experience

Do you have a fenced yard?

Yes No Partial

Do you agree to keep your foster dog leashed at all times when not in a fenced in area?

Yes No

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

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

What are you plans to exercise your foster? Please list any parks near by or trails, how many walks a day and approximate length.

Please list your most recent Veterinarian and 3 personal references with names, addresses, phone numbers and how related. We prefer it not to be all relatives. Are you ok with this?

Yes No

Vet Reference: Full Name *

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Vet Phone Number

Area Code Phone Number

Reference #1: Full Name *

First Name Last Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Reference #2: Full Name *

First Name Last Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Reference #3: Full Name

First Name Last Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Do you have anything else to share?

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 Collie Rescue of Greater Illinois (CRGI) animal fostered by me.

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

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

Date

Month Day Year