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APPLICATION TO FOSTER

Please fill out this form to apply to foster a rescue Dachshund

Application should be filled out by an adult in the household applying

Use your "tab" key to move between fields
Hit "Submit" when ready to send
(All fields are required--put 'N/A' if question does not apply to your situation)

First Name:
Last Name:
Address:
City: State: Zip:
Phone Number (with area code):
Alternate Phone Number:
Email address:

What type of home do you have?
House Mobile Home Apartment Condo

Do you own or rent your home?
Own Rent

If renting, does your landlord allow pets?      Yes No N/A

If yes, how many?

Are there stairs in the home?      Yes No

How many people are living in the home?

Please list family members and their ages (remember to include yourself):
(Application will not be considered without this information!)


Do you frequently have small children visiting your home?     Yes No

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

Where will the dog(s) sleep at night?
In their own bed
In a closed-off room
In bed with us
Wherever they want
Other

Do you have a fenced in yard?
No Block Wall Chain Link Wood Other

Do you have a pool?
No With security fence Open to the yard

Do you use a pool service, gardening service or a cleaning service?
None of the above
Pool service
Gardening service
Cleaning service
Pool and Gardening services
Pool and Cleaning services
Gardening and Cleaning services
All three

If you use one or more of the above, what steps do you take to prevent them from letting your pets out?
(Type "N/A" if you don't use any of the services)


Please list pets you now have in your home. Be sure to include the following information on each of your current pets:
Type/Breed              Sex     Spayed/Neutered     Age     Owned Since (age)

Are all your pets spayed/neutered?      Yes No

Would you foster a dog that:

Is older (6 yrs. and up)?     Yes No
Has been abused?      Yes No
Is not reliable with children?      Yes No
Has a physical handicap?      Yes No
Requires regular medication?      Yes No
Requires house training?      Yes No

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

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

Is there a limited amount of time you can foster? Yes No

References:
Name: Phone Number:
Name: Phone Number:

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

     

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