Business Case For System Enhancements

Foster Care Application

Please be advised that all potential foster homes will also be screened through a home visit by one of our volunteers. If you are not willing to accept this condition, you will not qualify to foster for the Boston Terrier & Pug Rescue of Southern Manitoba.

Name: Spouse's Name (if applicable): Occupation(s): E-Mail Address:

Home Phone: Work Phone: Cell Phone: Best Time To Call:

Street Address: City: Province: Postal Code:

Do you live in an: Apartment House Condo Other

Do you rent or own your home? Rent Own *Please note that renters must include documentation from the landlord that dogs are allowed to live in this dwelling.*

Does the primary animal caregiver work: Full-time Part-time Other

Will there be any provisions made if you are away during your foster care time?

On average how long will this dog be left alone each day?

Where will the dog be kept (ie. kennel, dog bed, run of the house, etc):  While at work?  At Bedtime?  While no one is home?  While on vacation?

Exercise/Elimination for this dog will be: Doggie Door Totally Fenced in Area Future plans for fenced area

Choose the type of fence you have: Wood Plastic Chain Link

Choose the height of your fence: 4 foot 5 foot 6 foot

Does your fence have any holes or gaps in it? Yes No

If yes, please provide details (size, location, etc.) *Please note that a fenced-in yard is required to be approved as a foster parent, unless you are living in a dog-friendly condominium or apartment, in which case we would expect the foster parent to abide by local leash laws at all times.*

1 | P a g e Foster Care Application

Please provide the name and contact information of your current veterinarian.  Vet Clinic Name:  Veterinarian's Name:  Clinic Address:  Clinic Phone Number: May we contact your vet for an animal care reference? Yes No

List ALL members in your household (including yourself):

Name Age Relation

Do you have children at home? Yes No

If applicable, have your children been around pets?

Would they be participating in the care of the animal fostered? Yes No

Please list all types of pets (Dogs, Cats, Gerbils, etc.) including breed, age and gender that currently live in this household:

Type Breed Gender Age Spay or Neuter

Do your pets accept other pets? Yes No

If not spayed/neutered, please explain why:

If you are a dog owner, is your dog vaccinated against bordetella (kennel cough)? Yes No * BTPRSM vaccinates all our foster dogs against bordetella and encourages all potential foster parents to vaccinate their own dogs against it as well. Our primary veterinarian has agreed to offer this vaccination at a reduced cost to participating foster families. If a foster family chooses not to vaccinate their own dog against bordetella, BTPRSM cannot be held liable for medical costs associated with an outbreak of bordetella in the home for owned dogs.*

Are your current dogs licensed with the City of Winnipeg or the town/community in which you reside (if applicable)? If you have lost a pet or it died at an early age or due to an accident, please provide details: 2 | P a g e Foster Care Application

Do you have any experience in training (housebreaking, basic commands)? Yes No

Are you willing to provide basic training for the fostered animal? Yes No

Do you have any specifications on the gender of Boston Terrier or Pug you would like to be placed with you? Male Female

Are you willing to foster either a Boston Terrier or a Pug? Yes No

If no, please provide preference, and if your preference is flexible at all.

Would you be willing to work with a dog that was not fully housebroken? Yes No *Note: the majority of dogs who come into rescue will need work on their housebreaking skills. Some will need to be entirely housebroken, especially those who came from living outdoors (ie. backyard breeder or puppy mill). Even dogs that come to us housebroken can have the occasional accident while the dog adjusts to its new surroundings and routine.*

Would you be willing to foster a dog with special medical needs? Yes No

Would you be willing to foster a dog with some behavioral problems? Yes No

Do you have any time constraints on the amount of time the animal can remain in your home? Yes No

Please list two other references we may contact regarding this adoption:

Reference #1 Name: Phone Number: Relation:

Reference #2 Name: Phone Number: Relation:

Additional comments:

 ALL DOGS PLACED IN FOSTER CARE REMAIN THE PROPERTY OF THE BOSTON TERRIER & PUG RESCUE OF SOUTHERN MANITOBA.  UNDER NO CIRCUMSTANCES MAY THE DOG BE REMOVED FROM THE FOSTER HOME BY ANYONE OTHER THAN THE BOSTON TERRIER & PUG RESCUE OF SOUTHERN MANITOBA.  THE DOG MUST BE RETURNED TO THE BOSTON TERRIER AND PUG RESCUE OF SOUTHERN MANITOBA UPON REQUEST.

3 | P a g e