EmailMe Form - Foster Application

Name *

First Last

Address, City, State and Zip Code

Phone Number *

### - ### - ####

Secondary Contact Number *

### - ### - ####

Email Address *

Re-type your email address *

Are there children in your home? Yes/No. Please list how many, their ages and relationship to you.

Are you currently employed? If yes, please provide your occupation, the name and contact information of your employer.

How many hours during the day will your dog be alone and where would it be kept? IE. Inside/outside, in a kennel inside, chained or freely roaming outside in the yard.

Are you single or married?

Single

Married

Have a partner

What is your spouse or partners name and age and are they aware you are seeking to foster a pet?

Have you ever owned or fostered a Yorkshire Terrier or any other breed? If yes, where is the pet now?

Are you or would you be willing to foster the pet until a permanent home is found? If no, how long would you be able to foster the pet?

Do you currently have any pets? If yes, please specify breeds, ages and sexes. Also list which ones are or aren't spayed or neutered.

Is there anyone in your home that objects to fostering a pet? If so, please explain why.

Are you pets current on their vaccinations? Please list which are or aren't.

Are any of your pets on heartworm medications? Please list which ones are.

Are any of your pets aggressive or have bitten anyone or any of your pets? If yes, please explain.

Do you live in a home, apartment or other? And do you own or rent?

If you rent, please provide your landlords contact information.

If you have a yard, is it fenced and what type of fencing is it? Short, tall, chain link, block wall? Is it a permanent fence and is there an entry/exit door to the backyard. And, is the yard secure/locked?

Is there a pool on your property or that your pet has access too? If yes, is the pool fenced? If not fenced, will you take necessary measures to ensure your pet cannot access, fall into or can climb out of the pool?

Will your pet be kept inside or outside most of the time? If outside, what type of shelter will be provided for it?

Do you already have a vet or a potential vet? If yes, please provide their contact information. And if you currently have a pet, when was the last time they were by a vet?

Can you provide 3 references and their contact information?

Do you agree with the terms and conditions? *

Yes, I agree.

Please Read The Following Carefully:

I declare that the information I have provided in this application is complete and correct. I further declare that I am physically able to care for a foster dog, specifically, a Yorkshire terrier. I understand that the Yorkie Rescue of America will reimburse me for pre-approved expenses after submitting a copy of the bill with the foster dog's name and ID# to Yorkie Rescue of America.
I understand that any food, toys, and travel expenses associated with the foster dog are a donation and will not be reimbursed. I understand the requirement and grant permission for Home Checks at random, both prior to and during fostering. I submit that if a Home Check reveals falsification or misrepresentation of any facts on my part, the Facilitator or representative reserves the right to either refuse fostering, to nullify any agreement between us and reclaim said Yorkshire terrier from my premises, without reimbursement of the fostering expenses.
I stipulate that I am applying herein to become a volunteer for Yorkie Rescue of America and I will provide automotive, homeowners and health insurance, and hold Yorkie Rescue of America or its representatives, its officers, members, volunteers, associates, or other foster care providers harmless for any liabilities, whether damages are physical, emotional, or property, that are a direct or indirect result of activities associated with placement, transport, grooming, training, or evaluating of any Yorkshire Terrier or other dog in any way associated with Yorkie Rescue of America, including any and all activities I perform as a volunteer for Yorkie Rescue of America. If accepted, I understand the first six months my membership will be probationary, and my membership may be dissolved immediately without cause if the Board of Directors deems my intentions or actions to be in conflict with the mission and vision of Yorkie Rescue of America.

I agree

I disagree