Application to Foster for Yorkie and Small Dog Rescue |
| |
|
| Your Full Name: |
|
| Your Age: |
|
| E-Mail Address: |
|
| Your Spouse's Full Name: |
|
| Your Spouse's Age: |
|
|
| Street Address: |
|
| City: |
|
| State: |
Zip-Code
|
| Home Phone: |
|
| Mobile Phone: |
|
| Your Employer: |
|
| Your Employment Phone # |
|
| Driver's License Number: |
|
| Spouse's Employer: |
|
| Spouse's Employment Phone # |
|
Important Questions |
| Please list the number of children you have and their ages: |
|
| How long have you lived in this address |
years |
| Dwelling Type: |
|
| Own or Rent? |
|
| Landlord's Name (if renting): |
|
| Landlord's Phone Number: |
|
| What living environment are you in?: |
|
| If less than two years, please list your previous addresses: |
|
| Please list the name and ages of anyone besides your immediate family residing in your home: |
|
| Does your house have a yard?: |
|
| Is your yard fenced in?: |
|
| Is the fence secured underground?: |
|
| Is someone home during the day?: |
|
| Where will the dog stay while you are gone?: |
|
| Where will the pet be kept most of the time?: |
|
| Have you ever owned a Yorkshire Terrier?: |
|
| If yes, where is that Yorkie now?: |
|
| Have you fostered a pet before? If so, please list what kind of pets: |
|
| List the names of agencies you have fostered pets from before: |
|
| What are you willing to provide for a foster pet? (for example: food, shelter, training, activities): |
|
| Prefer Male or Female Pet?: |
|
| Preferred Age Range?: |
|
| List other criteria for the pet you wish to foster here: |
|
| Are you willing to foster a dog until a permanent home can be found or other arrangements are made?: |
|
| If no, what is your maximum time frame?: |
|
| Are you willing to provide transportation to and from the vet, adoption sites, etc. as needed? |
|
| Other Pet Information |
| Please list what other pets you have and type of pet: |
|
| Are your other pets current on all vaccinations?: |
|
| Are your other pets on heartworm preventative?: |
|
| What type of heartworm preventative: |
|
| Are your other pets spayed/neutered?: |
|
| If not, please explain why: |
|
| Please list the names and phone numbers of your current and previous veterinarians: |
|
| If applicable, approximate date of your current pet's last office visit: |
|
| If you have owned other dogs and do not now, what happened to them?: |
|
| Some rescues may encounter some behavioral problems? Are you willing to work with us on correcting these problems?: |
|
| Please provide 3 personal references with names, addresses, phone numbers, and how related: |
|
| Additional Comments: |
|
YSDR Agreements |
- I certify that the information provided on this form is true and correct.
- I am also financially and physically able to care for this animal.
- I understand that proper food and incidentals may be costly and I am able to meet these requirements.
- Home checks are made on a random basis following or prior to placement.
- I understand that Yorkie and Small Dog Rescue will reimburse me for any pre-approved medical expenses and impound fees related to this dog.
- I also understand that I am responsible for any food, toys, and travel associated with fostering this dog, and that I will not be reimburse for it.
- I understand that I am a volunteer for Yorkie and Small Dog Rescue.
- I will provide my own automobile and health insurance.
- I hearby agree to not hold Yorkie and Small Dog Rescue or any of its volunteers, associates or foster care providers liable for any physical, emotional or property damages that are a direct or indirect result of activities involved in the placement, transport, grooming, training or evaluating of rescue dogs in any way associated with Yorkie and Small Dog Rescue. This includes any and all activities I perform as a Yorkie and Small Dog Rescue Volunteer.
|
| |
|
| Typed Full Name (Signature) |
|
| Today's Date: |
|
| |
|
 |
| Type the code (black letters only) in the box provided to prove you are human (anti-spam) |
|
By pressing submit, I hereby agree to the above terms and conditions given by Yorkie and Small Dog Rescue. |
