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RESCUE PROGRAM APPLICATION TO FOSTER |
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RESCUE PROGRAM APPLICATION TO FOSTER |
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* ABOUT YOU *
Name _______________________________________________________________ Age _____________________
Spouse _____________________________________________________________ Age _____________________
Address ______________________________________________________________________________________
City _____________________________ Province/State _________________ Postal/ZIP Code __________
Home Phone # _________________________ Will you accept a collect call from us? Yes [ ] No [ ]
Cell Phone # _________________________________________________________________________________
Email address(es) ____________________________________________________________________________
When is the best time to contact you? ________________________________________________________
May we contact you at work? Yes [ ] No [ ]
If yes, when is a good time to call? _________________________________________________________
Please indicate which best describes your current living situation:
House [ ] Condo [ ] Townhouse [ ] Apartment [ ] Mobile Home [ ] Other ______________
Do you Rent? [ ] Own? [ ] Live with parents? [ ]
If you rent, do you have your landlord's permission to foster a dog? Yes [ ] No [ ]
Name & phone number of landlord ______________________________________________________________
______________________________________________________________________________________________
What type of environment? City [ ] Suburban [ ] Country [ ]
How long have you lived at your current address? _____________________________________________
If less than two years, please list your previous address ____________________________________
Your employer _____________________________________________________ Phone ____________________
Job title ____________________________________________________ How long employed there _______
Spouse's employer _________________________________________________ Phone ____________________
Job title ______________________________________________________How long employed there ______
Number of children _______ Their name(s), gender(s) and age(s)________________________________
______________________________________________________________________________________________
Besides your immediate family, are there others residing in your home?
Names: Ages:
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Is everyone in your household in agreement on fostering a rescue dog?
Yes [ ] No [ ]
If no, who is not and why?____________________________________________________________________
______________________________________________________________________________________________
Does anybody in your home have allergies? Yes [ ] No [ ]
If yes, what are they allergic to?
______________________________________________________________________________________________
* ABOUT YOUR HOME *
What is the square footage living space in your home? ________________________________________
How much of this will the foster dog have access to? _________________________________________
Is there any part of your home the dog will not have access to? ______________________________
If yes, where and why? _______________________________________________________________________
Does your home have a fully enclosed fenced yard? Yes [ ] No [ ]
If yes, describe the fence (height, secured underground, invisible) __________________________
______________________________________________________________________________________________
Is there a gate? Yes [ ] No [ ] Can it be locked? Yes [ ] No [ ]
If there is no fence and gate, please describe how you will keep your dog secure on your
property.
______________________________________________________________________________________________
______________________________________________________________________________________________
How large is your yard approximately? ________________________________________________________
Do you own a Pool? Yes [ ] No [ ]
If yes, is it fenced separately? Yes [ ] No [ ] Above or in-ground? ____________________
* ABOUT YOUR LIFESTYLE *
Is someone home during the day? Yes [ ] No [ ]
Where will your foster dog be kept most of the time during the day? Please be specific.
______________________________________________________________________________________________
Where will your foster dog be kept most of the time at night? Please be specific.
______________________________________________________________________________________________
Approximately how many hours a working day will your dog be left alone? And on weekends?
______________________________________________________________________________________________
How often and what months do you go away on holidays?
______________________________________________________________________________________________
Will you have a dog run/dog house? Under what circumstances would you use the dog run/dog
house?
______________________________________________________________________________________________
What activities do you plan to do with your foster dog?
______________________________________________________________________________________________
Who will be the primary caregiver to the dog? (walks, feeding, grooming, training)
______________________________________________________________________________________________
What do you plan to feed your foster?
______________________________________________________________________________________________
Why do you want to foster a rescued dog?
______________________________________________________________________________________________
Under what circumstances would you return the foster dog to rescue?
______________________________________________________________________________________________
* DOG PROFILE INFORMATION *
Which of the following best describes the dog that you are looking to foster?
AGE ______________________________
ACTIVITY LEVEL ___________________
GENDER ___________________________
[ ] puppy (6 mos to a year)
[ ] moderate
[ ] male
[ ] teenager(1-2 years)
[ ] active
[ ] adult (2-7years
[ ] veryactive
[ ] senior (8 years)
[ ] no preference
* YOUR OTHER PET INFORMATION *
Have you ever owned a dog? Type (list breed, age, sex) _______________________________________
______________________________________________________________________________________________
If yes, where is that dog now? _______________________________________________________________
Do you have other pets? Type (list breed, age, sex) __________________________________________
Where did your current and previous pets come from? (if applicable) __________________________
Pet Store [ ] Breeder [ ] Shelter [ ] Rescue Society [ ] Other [ ] ___________________
Are your other pets current on all vaccinations? _____________________________________________
If yes, approx date of pet's last office visit _______________________________________________
Are your other pets spayed/neutered? _________________________________________________________
Are your animals on heartworm preventative if applicable, and if so, what type? ______________
______________________________________________________________________________________________
If not, why not? _____________________________________________________________________________
* OTHER INFORMATION *
How did you hear about BCOC Rescue? __________________________________________________________
Have you applied to foster an animal with any other organizations/rescues in the past year?
______________________________________________________________________________________________
List any humane societies, organizations, breed or training clubs you are associated with:
______________________________________________________________________________________________
We will attempt to provide you with an honest evaluation of temperament on any dog we have to
place, however, do you realize that often the complete history of a rescued dog may not be
known and you may encounter some behavioural problems? Many rescue dogs have problems with
fearfulness, fear aggression, separation anxiety and house training to name a few. Would you
be willing to work on retraining your foster dog? Yes [ ] No [ ]
* REFERENCES *
Please provide the name, relationship to you, address and phone number of 3 personal
references (maximum of one family member), as well as your veterinary reference. If you have
no previous veterinary history, please include a 4th reference (not a family member).
VETERINARIAN
(1) Veterinarian's name & phone number: (or name of the one you intend to use) _______________
______________________________________________________________________________________________
Name under which the animals are registered at the vet's office (pet's name and owner's name)
______________________________________________________________________________________________
Personal References:
(2) Name & Relationship to you _______________________________________________________________
Phone # & email address ______________________________________________________________________
(3) Name & Relationship to you _______________________________________________________________
Phone # & email address ______________________________________________________________________
_
(4) Name & Relationship to you _______________________________________________________________
Phone # & email address ______________________________________________________________________
(5) If no veterinary reference is available __________________________________________________
Name & Relationship to you ___________________________________________________________________
Phone # & email address ______________________________________________________________________
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Space for additional comments:
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I have contacted my vet and references already. Yes [ ] Not yet { ], but will have done so
by (date) ____________________________
By signing this document.................
I/we understand that BCOC Rescue will be responsible for any medical or other approved
expenses associated with the foster dog in my care.
Note: If injuries or medical treatment is required as a result of negligence on the part of
the foster home, the foster home will be held responsible for covering the costs of
treatment.
I/we understand that by signing this form I/we agree to release and covenant to hold
harmless BCOC Rescue, and its members from any claims, damages, costs, or actions incurred
as a result of the foster care or actions of the foster dog.
I/we will notify BCOC Rescue immediately should the foster dog become lost, stolen, and ill
or die.
I/we agree to contact my BCOC representative at least once per week to update her/him on
the condition and well-being of the foster dog.
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BCOC strongly discourages and will not tolerate training or behaviour modification through
physical violence of any sort. We will not condone nor tolerate hitting, ˜spanking" or
any other form of physical punishment.
All foster dogs must wear an I.D. collar with the foster home telephone number and the
telephone number of your BCOC Representative at all times.
The foster home agrees to provide high quality food for the foster dog at his or her own
expense. Treats, toys, beds, etc. are also the responsibilities of the foster home. BCOC
Rescue will try to help with these incidentals wherever possible.
BCOC reserves the right to perform unannounced visits to the foster home at any time.
BCOC reserves the right to remove the dog from your premises at any time, without
justification or notification. Note: If BCOC judges the foster dog to be in danger, this
signed document allows BCOC to remove the dog from said premises without warning.
The foster home understands that BCOC cannot predict the behaviour of any dog in any
situation. BCOC will provide any relevant information on the dog's history and temperament
that is known. This information may or may not be a reliable indicator of how the dog will
behave in a new environment, including your home.
**********************************************************************************************
Home visits are mandatory prior to fostering and may be made on a random basis after a dog is
placed in your home to foster. If upon inspection we find that information contained in this
application to be false, we retain the right to turn down your application or remove the
animal from your premises. We reserve the right to refuse a foster applicant due to our
primary interest being the well-being of the animal. We require a hard copy of your signature,
certifying the above information. Your signature also indemnifies the BCOC Rescue, and
representatives thereof, from any & all liabilities that may occur due to fostering any
rescues.
**********************************************************************************************
I/We certify that the information provided on this form is true & correct. In signing this
document, I/we am/are granting permission for a BCOC Representative to contact all stated
references & veterinarian(s). I/We am/are physically able to care for this foster animal.
I/We understand that proper food, water and shelter is necessary, and I/we am/are able to meet
these requirements.
By typing my/our name(s) here, please consider this as my/our electronic endorsement of the
veracity of this application.
Signature Date
Signature Date
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Instructions re. completing and Emailing the above form: (1.) From the "Edit" drop-down list at the top of your browser (in which you are viewing this form), click on "Select all...." (2.) From the same drop-down list, click "Copy". (This will now copy the form onto your computer's clipboard.) (3.) Open your favourite word processor, such as "MS Word", "Open Office", or "WordPerfect". (4.) Then open a blank document in your word processor. At the top of this word processor program, access "Edit", and click on "Paste". The form now appears in your word processor, and you can complete and edit the form at your leisure. (5.) At any time, this form can now be "Saved As........", using the following file-naming format.... "YOURSURNAME.FOSTERAPP". Ensure that it is stored in a convenient location on your computer where it can be found easily and readily used as an Email attachment. (6.) Send an Email to Bob Brewster (the National BCOC Rescue Program Co-ordinator) with the Subject: field containing the phrase "YourSurname.FosterApp". (7.) Attach the above saved file to this Email, and then click "Send". (8.) An acknowledging Email will be returned to you when the application is read, processed, and filed. |
