Foster Home Application

Foster Application
Personal Information
Full name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home phone number*

Area CodePhone Number
Cell phone number

Area CodePhone Number
Work phone number

Area CodePhone Number
Age of applicant (s):

18-2930-5455-6464 or above
Occupation of applicants:
Do you have experience handling animals?*

YesNo
Please describe:
Please describe:
Have you ever owned a pet before?*

YesNo
For pets previously owned, but no longer with you, please explain and provide the reason. (eg. passed of old age, re-homed, took to shelter, euthanized)
For pets previously owned, but no longer with you, please explain and provide the reason. (eg. passed of old age, re-homes, took to shelter, euthanized)
Would you say that you have experience handling dogs with medical or behavioral issues?*

YesNo
If yes, please give us some details.
If yes, please provide the details.
Household Dynamic
Do you have any children living in your home?*

YesNo
If yes, how many and how old are they?
If yes, how many and how old are they?
Do you have any other people living with you?*

YesNo
If yes, please explain.
If yes, please explain.
Does anyone in your home have allergies to animals? Please explain.*
Does anyone in your home have allergies to animals? If so, please explain.
Is everyone in your household equally enthusiastic about fostering a pet? Please explain.*
Is everyone in your household equally enthusiastic about fostering a pet? Please explain.

Are you or your spouse/roommate presently:

	You	Other	Both
At home
Attending school
Working outside the home
Retired
Other
Hybrid work arrangement

How many hours during an average day will your foster dog be left alone?
How would you describe the activity level in your household?

LowMediumHigh
Describe the activity
Describe the activity.
Do you have any pets in the home at the moment?*

YesNo
If yes, please tell us a bit about your pets (age, breed, temperament, etc)
If yes, please tell us a bit about your pets (age, breed, temperament, etc)
Are your current pets' vaccinations up to date?*

YesNo
If required, are you able to supply proof of vaccinations?*

YesNo
If your pets are not up-to-date with their vaccinations, please let us know why.
If your pets are not up-to-date with their vaccinations, please let us know why.
Are your pets spayed or neutered?*

YesNo
If required, are you able to supply proof of alteration?*

YesNo
If your pets are not spayed/neutered, please let us know why.
If your pets are not spayed/neutered, please let us know why.
Environmental Information
What is your housing situation?
If you rent, do you have permission to have pets?

YesNo
Landlord's name

First NameLast Name
Landlord's phone number

Area CodePhone Number
What type of home?
Does your residence have stairs?

YesNo
How will your new foster be confined to the property? Please check all that may apply.

HouseKennelFenced YardChainedPatio Area
Do you have a fenced yard?

YesNo
What type of fence do you have?

WoodChain LinkOther
How high is your fence?*
How high is your gate?*
Is it possible for a dog or puppy to crawl or dig under the fence?*

YesNo
Is there an area in your home where your foster dog can be isolated?
Is there an area in your home where your foster dog can be isolated?

YesNo
Please describe.
Foster Matching
Are you able to foster a dog of any age? *

YesNo
If not, please let us know why.
If not, please let us know why?
Are you able to foster male and female dogs?*

YesNo
If not, please let us know why.
If not, please let us know why.
Are you willing to foster a dog until it is adopted, as long as it takes, barring unusual circumstances?*

YesNo
If not, please let us know why.
If not, please let us know why.
Foster Responsibilites
Are you willing to take the time to work with a foster dog on housebreaking issues or other issues as they arise?*

YesNo
Do you agree to keep your foster dog leashed or in a securely fenced area at all times?*

YesNo
Do you agree to keep a collar and harness with an ID tag on your foster dog at all times?*

YesNo
Do you have reliable transportation to take a foster dog to medical appointments, training assessments and events?*

YesNo
Do you agree to "puppy proof" your home and remove/store/lock up items that could be damaged or ingested?*

YesNo
Do you understand and accept that dogs can cause damage to your flooring, furniture, vehicles and belongings by chewing, scratching and having accidents?*

YesNo
Do you agree to relieve and absolve hart and any of its members of any responsibility for said damages should they occur?*

YesNo
Would you be willing to have a hart representative do a home visit prior to fostering?*

YesNo
Additional Information
How did you hear about hart?*

FriendSocial MediaNewspaperVeternarianPublic EventStore DisplayOther
Comments
Comments.
Should be Empty:

Foster Application

Personal Information

Household Dynamic

Environmental Information

Foster Matching

Foster Responsibilites

Additional Information