EmailMe Form - FOSTER APPLICATION

Date

Dog Interested In

What age/sex of dog do you prefer?

Name *

First Last

Age *

Email *

Phone *

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

Address *

Street Address City State / Province / Region Postal / Zip Code

Employer

Employer Phone

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

Spouse's Information

Spouse's Name

Spouse's Email

Spouse's Employer Phone

Spouse's Employer

Personal Reference #1

Reference Name *

First Last

Reference Phone *

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

Reference Email *

Best Time to Call *

Personal Reference #2

Reference Name *

First Last

Reference Phone *

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

Reference Email *

Best Time to Call *

Your Veterinarian

Veterinarian Name *

Veterinarian Phone

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

Do you know if your vet will offer a discount for Rescue foster?

Pets

Have you ever owned a Coonhound or Bloodhound?

Why do you want to foster a Coonhound or Bloodhound?

Pet #1 Currently Owned

Type/Breed
Sex
Spayed or neutered?

Age
How long owned?
Inside or outside?

Pet #2 Currently Owned

Type/Breed
Sex
Spayed or neutered?

Age
How long owned?
Inside or outside?

Pet #3 Currently Owned

Type/Breed
Sex
Spayed or neutered?

Age
How long owned?
Inside or outside?

Your Housing Situation

Do you *

Do you have a securely fenced yard?

If no fenced yard,are you willing to

Your Household

Number of Adults in Household

Number of Children in Household

Ages of Children in Household

How much contact with grandchildren/neighborhood children/other children?

Are any of your household members frail or fall risks?

If yes, please describe.

Do any of your household members have animal-related allergies?

If yes, please describe.

Dog Fitting Into Household

Who will be primarily responsible for the care of the dog?

What are the working hours of the adults in the household?

Where will the dog sleep at night?

Where will the dog be kept during the day?

How many hours per day will dog be left alone?

Where will the dog be kept when left alone?

Please describe how you will exercise the dog

Please tell us what characteristics
are undesirable. Please answer with as much detail as possible.

Please include any additional comments, information, etc. below that would help us help you find that perfect foster home for your home and environment.

Please type your name below to signify your understanding and agreement that the dog is legally owned by American Black & Tan Coonhound Rescue, Inc. ("Rescue"), and that any decisions regarding the dog's care, location, transportation and disposition will be made by Rescue. At any time, Rescue may require the dog be returned to it. *