Dog/Puppy Foster Home Application

APPLICANT INFORMATION

APPLICANTS MUST BE 18 OR OLDER.

Foster Home Applicant *

First

Last

Applicant 2 *

First

Last

Address *

Address Line 1

City

State / Province / Region

Postal Code

Mobile Phone *

Home Phone

Email *

Employment Status *

Employed
Student
Retired
Other

Please provide details *

FAMILY INFORMATION

Please tell us about you and your family.

Does anyone in your home have pet allergies? *

Yes
No

If yes, please explain *

What type of home do you reside in? *

House
Condo
Duplex
Apartment

Do you own or rent your home? *

Own
Rent

Please provide landlord’s name: *

Landlord’s phone number: *

How long have you been at your current address? *

Do you have children at home? *

Yes
No

What are the ages of your children? *

Are the children accustomed to and educated about animals? *

Yes
No

Why do you (and your family) want to foster? *

Have you ever owned a dog before? *

Yes
No

Do you presently own any other animals? *

Yes
No

Please specify past and present animals in your home, including name, age, breed, gender, if they are spayed/neutered and if their vaccines are up to date. *

Please provide the name of the veterinary clinic your animal(s) attend or did attend. *

Please provide the phone number of the above veterinary clinic. *

REFERENCES

Please provide the name and phone number of two (NON-FAMILY) references that are aware of you and/or your families’ interaction with pets (ie: vet, neighbour or friends):

Reference 1 *

First

Last

Phone *

Reference 2 *

First

Last

Phone *

REGARDING THE DOG(S)

What age of a dog are you able to foster? *

Puppy
Adult
Senior
Any Age

What gender of dog are you able to foster? *

Male
Female
Any Gender

Would you be able to foster an animal with special/medical needs? *

Yes
No

Are you comfortable giving injections, eye drops, and/or required medications? *

Yes
No

Will you be able to transport the foster dog(s) to and from veterinarian and grooming appointments? *

Yes
No

How much time are you able to spend with this dog per day? *

4 hours or less
4-8 hours
8 hours or more

Where will the dog be kept when you (and your family) are not home? *

If the dog showed behavioural problems how would you correct its behaviour? (ie. biting, growling, potty accidents, food or toy aggressions, and scratching) *

Would you be willing to contact Persian Dreams & Canine Themes Rescue Society for advice and suggestions to help you and your foster dog to be successful if there are behaviour concerns? *

I/We would be willing to contact PDCT for advice.

Do you have a fenced yard? *

Yes
No

If yes, what is the height and what kind of fencing is it? *

If no, how do you plan on keeping the dog securely in your yard? *

ADDITIONAL INFORMATION

Do you have any additional information you would like to share with us? *

Yes
No

If there is anything additional you would like to add, please do so here: *

FOSTER HOME TERMS

Please read and agree to the following Foster Home terms:

I/We agree foster animal(s) needing to see a veterinarian to contact the Veterinary contact person who will notify the clinic of the animal’s reason for visit and arrangements will be made. *

I/We Agree

I/We have reviewed the City’s Responsible Animal Ownership Bylaw and will review the PDCT Foster Home Handbook. *

I/We Agree

I/We agree that at anytime I/we are going to be away (out of Medicine Hat) I/we will call the Foster Home Coordinator so arrangements can be made as necessary. *

I/We Agree

I/We agree that any and all dogs I/we foster for PDCT will be kept on a leash at all times. *

I/We Agree

I/We acknowledge that all the information contained in this form is true and correct to the best of my/our knowledge. *

I/We Agree

I hereby state that Persian Dreams & Canine Themes Rescue Society is not liable for any destruction of property, or aggressive behaviour, from a foster animal. I understand that PDCT has evaluated, to the best of their ability, to place with me/us a compatible animal. I understand also, that I must be in control of my own animal(s) at all times and in control of the foster animal(s). *

I/We Agree

I hereby state in this agreement, that if in fact; the foster dog in my/our home is not working out and must be removed, to allow adequate time for re-placement (up to three weeks). *

I/We Agree

I hereby state that Persian Dreams & Canine Themes Rescue Society will provide the foster animal with the basic necessities it will need. This includes food, collar, leash, harness, and medical costs. *

I/We Agree

Any contributions from the foster home such as toys, food, paying vet bills, etc. is very welcomed and appreciated; however, it is not a requirement.

FOSTER HOME TERMS ACCEPTANCE

Applicant Signature *

Date *

Applicant 2

Date

Dog/Puppy Foster Home Application

APPLICANT INFORMATION

FAMILY INFORMATION

REFERENCES

REGARDING THE DOG(S)

ADDITIONAL INFORMATION

FOSTER HOME TERMS

FOSTER HOME TERMS ACCEPTANCE

The information provided in this document is confidential and will only be shared with the adoption applicant’s consent.