SNSR
FOSTER HOME APPLICATION

 

Name:  _________________________________________________________________________

Street Address: __________________________________________________________________

City/State/Zip:  ___________________________________________________________________

Phone:   ________________________________________________________________________

E Mail:  _______________________________________________________

What can you foster? Sick ___  Injured ____  Healthy _____ Nursing Mothers /pups _________

Can you deal with behavioral/temperament problems?  Yes _____  No _____   If Yes please explain.

 

How many dogs can you foster at one time?  _______

 

How long are you willing to take responsibility for this foster dog?  ________________

 

Where do you live?   Single family Home ____  Apartment _____  Mobile Home _____  Other  ______

 

Do you rent or own your own home?   _________

 

Any covenants or restrictions that prevent you from having a pet?      Yes______  No_____IF yes

please explain.___________________________________________________________

 

Do you have a totally enclosed, secure yard?   _____________

 

Describe the fence- height, wood or chain link and area size.  ____________________

 

How do you plan on exercising the dog?  ___________________________________

 

Can we contact your vet?    Yes______   No  _______

 

Vet Name:  ____________________________

 

Vet Phone:  _____________________________

 

I acknowledge that all the information contained on this form is true and correct.

I understand that any misrepresentations of fact may result in the removal of the foster dog from my home.

Agree:  ________  Do Not Agree:  _________

Signed:   _______________________________________   Date: ______________

SNSR Representative:    ___________________________   Date:  ____________. 

By submitting this form you acknowledge and agree to the terms below
Foster Home agent or Volunteer  being of lawful age, do now release, acquit and forever discharge SNSR, its Agents and Assigns, from any and all actions, claims, demands or damages accruing to me resulting from any known or unknown injury, loss or damage, sustained by me as a result of acting as a SNSR foster agent or volunteer. 
I ACKNOWLEDGE THAT ALL THE INFORMATION CONTAINED ON THIS FORM IS TRUE AND CORRECT. I UNDERSTAND THAT ANY MISREPRESENTATIONS OF FACT MAY RESULT IN THE REMOVAL OF THE FOSTER DOG FROM MY HOME