Shiba Rescue of New England

Foster Application

Full Name: ________________________

Age:	________________________

Email:	________________________

Address:	________________________

________________________

Cell #	________________________

Do you live in a:

Condo/townhouse:	__________

Single family:	__________

Apartment:	__________

Do you:

Own:	__________

Rent:	__________

Live with Parents:	__________

Other:	__________

If renting, please indicated landlord contact info:	_____________________________________________________

Household setting:

Rural:	___________

Suburban:	___________

Urban:	___________

Describe your homes activity level:

Busy/Noisy:	____________

Moderate Comings/goings:	____________

Quiet with Occasional Guest:	____________

Please list all the people living in the household, including gender, age, relationship:

___________________________________________-

Is anyone in the household allergic to animals?	___________

Are all members in the household agreeable to fostering a dog?	________

Who will be the primary caretaker?	_______________________

__________________________________________________

Please list all pets presently in household, including type, breed, age, temperament: ___________________________________

_________________________________________________

_________________________________________________

Please list former types of pets and/or animal experience:	________________________________________________

Do you have a preference of gender for fostering?

Male:	_________________

Female:	_________________

No Pref.	_________________

Are you willing to foster a dog of any age?

Yes:	__________

No:	_________

Age Restrictions:	_________

Are you willing to take your foster dog to vet appointments at a convenient time for you?

Yes:	_________

No:	_________

Are you willing and able to medicate your foster, even if it is monthly heartworm preventative provided by the Rescue?

Yes:	______________

No:	______________

We cannot guarantee a dog will be housebroken, are you equipped to train with love and patience?

Yes:	_________

No:	_________

Have you ever had experience with an emotionally or physically neglected or abused dog?

Yes:	______

If so, please describe:	____________________________

_______________________________________________

No:	__________________________________________

Do you have a fenced yard?

Yes:	___________ Please give details on height, material, # of gates and if gates are lockable:	_____________________________________

Partial:	____________________________

No:	_________________

Dog Park close by:	______________________

How many hours will the dog be left alone?	____________

What does a typical day look like for your foster and your schedule?	_________________________________________________________________________________________________________________________________________________________________________

Please list one personal reference with contact information. We prefer someone who is not a relative, and is knowledgeable of your ability to care for animals.

____________________________________________________

____________________________________________________

Your vet contact info:	_______________________

________________________________________

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in forfeiture of any Shiba Rescue of New England dog fostered by me.

I agree to have Shiba Rescue of New England complete reference call checks and conduct a home visit or virtual visit inspection in order to further consider my application.

I accept full responsibility for the dog’s actions at all times, and release Shiba Rescue of New England from any liabilities or damages that may be incurred because of fostering such dog(s).

I agree that if I am unable to foster the dog(s) any longer, that I will return the dog(s) to Shiba Rescue of New England and try to give Shiba Rescue of New England a 1 week period to try and find another suitable foster for the dog(s).

I certify that the above information is correct, and will also be verified.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Shiba Rescue of New England and its members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog.

Your name:	___________________________

Date:	___________________________

Email:	____________________________