Foster Application

If you wish to download a copy of this application you can download the form here: Foster Application (Microsoft Word format)

Foster Parent Application

• Name of Foster Applicant *

• Birth Date *

• Address *

• City *

• State *

• Zip Code *

• County *

• Length of time at this address *

• Email Address *

• Occupation *

• State Drivers License # *

• Day Phone *

• Cell Phone

• Evening Phone *

• Emergency Contact Information

• Name *

• Phone Number *

• Co-Applicant’s Name:

• List of names and ages of ANY children living in home or visit on regular basis (please include relatives and friends) *

• List below any cats, dogs, or other animals who currently live in your household

• Name

• Breed

• Age

• Gender

• Spayed / Neutered

• Owned how long

• Kept where

• Name

• Breed

• Age

• Gender

• Spayed / Neutered

• Owned how long

• Kept where

• Name

• Breed

• Age

• Gender

• Spayed / Neutered

• Owned how long

• Kept where

• How does your dog(s) react to other dogs? (friendly, submissive, growl, etc…)

• Are ALL dogs in your household current on ALL recommended and/or required vaccinations?

  yes   no

• Please list the dates of the last vaccinations

• Rabies

• DA2PP

• Bordatella

• Other

• What heartworm preventative are you currently administering to your pets?

• Have your pet(s) ever been diagnosed and/or treated for heartworms?

  yes   no

• If yes, please explain

• Please provide the contact information of the veterinarian you use.

• Vet Name

• Vet Phone

• Vet records are under the name of

• Will/does this vet or another vet in your area work with rescue organizations and give them discounted prices for services rendered?

• Household Information

• Home (Select One): *

  Own   Rent

• Type of house (Select One):  *

  single family   townhouse   condo   apartment

• Are you moving in the near future? (Select One) *

  yes   no

• If so, please explain:

• If you own your home,

  provide the home insurance carrier you use – many have breed restrictions.

• Insurance Company:

• Phone:

• if you rent your home,

  you MUST provide your landlord’s contact information for verification – many have breed restrictions.

• Landlord Name:

• Phone:

• Fences

• Do you have a fenced area on your property?  *

  yes   no

• What type of fencing do you have?

  privacy   split rail   metal   wood   other

• Is the area completely fenced?

  yes   no

• How high is the fence? (In Feet)

• Does the fence have a lockable gate?

  yes   no

• Approximately how many square feet of space is fenced area (length x width):

• Exercise

• If you don’t have a fence, how do you plan to have your dog relieve/exercise itself?

• Do you realize even with a fence that dogs need to be leash-walked every day?

  yes   no

• How active is your lifestyle aside from work? Please explain: *

• Do all adults work full time?  *

  yes   no

• If no, please explain:

• How many hours each day will your foster dog be alone?  *

• How many hours each day will you spend time with your foster dog?  *

• Where will your new dog be kept when it is alone?  *

• Where will your foster dog sleep?  *

• Are you familiar with crate training? *

  yes   no

• Do you have a crate available to use with your foster dog?  *

  yes   no

• Training

• What type of dog training experience do you have? *

• Are you aware that your foster dog may be an adult, with an unkown history, and no prior training? *

  yes   no

• Are you aware that your foster dog may chew, dig, bark, jump, or display other undesirable behavior while in your care?  *

  yes   no

• Have you ever taken an obedience course with your dog?

  yes   no

• Is your dog obedience trained?

  yes   no

• Are you willing to work with your foster dog in areas such as basic obedience and house training?  *

  yes   no

• Have you had any experience in introducing new adult dogs into your household? *

  yes   no

• If yes, please describe how this was accomplished

• Are you familiar with the concept of who in the household is Alpha or Top Dog?  *

  yes   no

• If yes, please explain your understanding of who Alpha is

• Should a disagreement or fight occur between your dog(s) and a foster, how would you handle the situation? What actions would you take to avoid this situation? Please be as detailed as possible in your response

• Are you willing to supervise any children around your foster dogs AT ALL TIMES?  *

  …yesno

• Please describe the type(s) of foster dogs you are willing to have in your home. (i.e. seniors, puppies, adults, male, female, special needs dogs (those who may be deaf, blind, recuperating from surgery or with other medical disorders such as epilepsy, thyroid, etc.)

• How may dogs are you willing to foster at one time? (on occasion there may be a pair that need to stay together if possible)

• Is there a preferred activity level for a dog you would want to foster?

• Please describe your level of experience as a dog owner and provide and honest assessment of your abilities to recognize and deal with any problem behaviors a foster dog might exhibit. (i.e. barking, growling, possessiveness of food or toys, chewing, digging, jumping, etc.)

• IMPORTANT

  *Submission of this application does NOT guarantee placement of a foster dog through Break the Chain Pit Bull Rescue*

• I confirm all information contained herein is true and accurate to the best of my knowledge and agree to conform to the aforementioned requirements of care.

• Signature

• Date

• If completed via email you can sign this document when you meet your first foster dog.

• Supporting breeders is not what we need to do when there are so many homeless bully breeds in the U.S. We need to find loving, responsible homes for the many dogs that are already here and dying in shelters every day.

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