Name *

First Name

Last Name

Spouse's name: *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Alternate Number

(###)

###

####

Personal reference *

First Name

Last Name

Phone number *

(###)

###

####

Do you have experience in any of the following areas? *

Rescue

Fostering

Vet Tech

Microchipping

Grooming

Behavior training

Kennel

Other

Have you ever fostered for another rescue? *

Yes

No

Do you understand that dogs are unpredictable and most dogs that come into rescue come with an unknown history? JDR cannot guarantee the dog you are working with will not become uneasy or on edge. *

Yes

No

Do you agree that JDR is not responsible for Dog bites, Injuries, Damages to property or to any animals. *

Yes

No

How many adults are in your home? *

One

Two

Three

Four or more

How many children are in your home? *

Zero

One

Two

Three

Four or more

Do you have elderly people who visit your home? *

Yes

No

Residence type: *

House

Apartment

Townhome

Condo

Do you: *

Own

Rent

If rented, are you allowed to have dogs? *

Yes

No

Do you have a fenced yard? *

Yes

No

Type of fence: *

Wooden

Chain link

Wrought iron

Kennel run

Locks on gate

Do you have a pool? *

Yes

No

Will the dog have access?

Yes

No

Do you have other pets? *

Yes

No

Are your current pet spayed or neutered? *

Yes

No

Are your pets up to date on current vaccinations? *

Yes

No

If needed - do you have a way to separate your foster dog from your current pets? *

Example - crates or baby gates.

Yes

No

Have you ever fostered for another rescue? *

Yes

No

Do you understand and agree that JDR requires all dogs to be kept as indoor animals only? *

Yes

No

Do you have a crate of appropriate size available? *

Yes

No

Do you understand that you may be required to transport the foster dog to a JDR approved veterinarian's office for appointments? *

Yes

No

Are you willing to administer medication if needed? *

Yes

No

Are you willing to foster a dog that may have behavioral issues? *

Yes

No

Do you understand that if you are no longer able to care for the foster dog that you need to give JDR ample time to make other arrangements? *

Yes

No

Do you understand that you are not permitted to adopt out the foster dog yourself? *

Yes

No

Do you agree to follow all guidelines and rules listed above pertaining to your foster dog? *

Yes

No

Date *

MM

DD

YYYY