EmailMe Form - Last Call Rescue Foster Application

Dog Application for Foster Home Care

Thank you for your interest in fostering a dog. So that we may find the right home for the right dog, we ask that you answer the following questions as completely as possible.

*Applicants must live within 300 Miles of Las Vegas, NV.

Name *

First Last

Email

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Primary Phone *

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

Secondary Phone

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

Birthday *

MM / YYYY

Household

Please list the names, ages and relation of all adults in the household. If none, write none: *

Please list the names, ages and relation of all children in the household. If none, write none: *

Dwelling Information

What type of housing do you live in? *

Do you own or rent your home? *

Own

Rent

How long have you resided at this address? *

Do you have a fenced-in yard? If so, briefly describe it.

If you don't have a fenced in yard, please describe how do you plan on exercising your foster dog?

Have you owned a dog(s) before? If so, what particular breeds?

What kind of experience have you had/have with dogs? (dog training, vet tech, groomer, agility, happy pet owner, etc). *

Have you ever fostered an animal before? If so, what was your experience?

What pets do you currently own? How long have you owned them?

If you currently own a dog(s), are they spayed/neutered?

Yes

No

How many hours per day will the foster dog be left alone? *

Where will the foster dog stay during the day? During the night? *

Who will be the primary caretaker of the dog? *

Does anyone in the household have allergies? *

Yes

No

If there are no children living with you, are there children that visit, for example, grandchildren, children you babysit, etc?

How often do you travel? Are you planning a vacation in the near future? *

Have you ever crate trained a dog? *

Yes

No

Are you willing to have someone from Foster Me visit your home for a home visit? *

Yes

No

Are you willing to cover the costs of caring for a foster dog except for medical expenses? *

Yes

No

Personal Reference Information

Please supply names and telephone numbers for 2 personal references, including your veterinarian. *

Full Name & Telephone #
Full Name & Telephone #

Dog ID #
(please add a 2nd and 3rd choice in case first dog is unavailable)

ELECTRONIC SIGNATURE

BY TYPING MY NAME BELOW I AUTHORIZE THAT ALL OF THE INFORMATION I HAVE PROVIDED ON THIS APPLICATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND COMPLETE. I UNDERSTAND THAT FALSIFYING ANSWERS ON THE APPLICATION, OR AT ANY OTHER TIME DURING THE FOSTERING PROCESS, DISQUALIFIES ME FROM FOSTERING. *

FOSTER CARE AGREEMENT

I understand and agree to all information provided to me in my application process. If the animal I foster is on medication I will continue the medication as directed. I will not let the animal out loose by itself. If during the time I am fostering the animal it requires medical attention I will contact the Foster Me of California first unless it is an emergency. I understand the foster animal is the property of Foster Me and will not sell, trade or dispose of the animal. I understand the importance of my own animals being up-to-date on all standard vaccinations and have provided Foster Me with a current shot record for each one.

Yes

No

I understand that anyone interested in adopting my foster dog, cat, puppies or kittens (including myself) must go through the standard adoption process, and approval of candidates and placement of animals is up to Foster Me (Of course we welcome your referrals PLEASE!)

Yes

No

Electronic Signature of Foster Parent

First Last

Today's Date *

MM / DD / YYYY