Name / Type of Dog You Would Like to Foster

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Date: Foster Application Processed By:

Name / Type of Dog You Would Like to Foster:

Your Name/ Age (must be 21yrs of age):

Street Address: Town/State/Zip

Home/Cell Phone #: Email:

Place of Employment: # of yrs Driver’s License #

Number of People in Your Household: Children’s Ages

Do you currently have pets living with you now? Y______N If yes, include Name, Age & Breed of Pet/s:

List all pets you have had in the last 10 years. Please include Name, Age, Breed and Year Deceased:

Are your pets spayed/neutered Y______N ______* We only adopt to households where pets are spayed or neutered *

Do Your Pets Get Along with Other Pets? Y______N ______What precautions would you take to properly introduce a new dog into your home if you have other animals?

If a disciplinary or behavior problem arises, what steps will you take to work on it?

Have You Ever Had to Give Up a Pet? Y______N If so, why?

Do You Have Experience with Animals? Y______N How Many Hours a Day Will Dog Be Left Alone?

Where Will the Dog Be Kept When You Aren’t Home?

Where Will Your Dog/s Sleep at Night?

Do You Have a Fenced-in Yard? Y______N If yes, type and height:

Do You Rent or Own Your Home? If you own, pls specify if Private House Condo/Co-op

If You Rent, Please List Landlord’s Name /Phone Number:

Does Your Municipality have Breed Specific Restrictions? Y _N Don’t Know How Do You Plan to Give the Dog Daily Exercise?

Is it Ok for Road to Home to Visit Your Home for a Home Check? Y N

Have you ever had an application declined for adoption of an animal from an animal welfare group/animal control facility?

If yes, please explain Y N

VET REFERENCE – Please list NAME and PHONE # of Veterinarian for current and/or previous pets NAME PHONE #

PERSONAL REFERENCES - Please list two references that are NOT family members. NAME: PHONE #: NAME: PHONE #:

As the foster guardian for this animal, by signing this agreement you agree to:  Care for the animal as if he were my own.  Feed, provide fresh water, walk and exercise the dog daily.  Return phone calls from Road to Home within a reasonable amount of time.  Allow Road to Home to make any visits they request to visit the animal.  Understand that the animal is going through a stressful time and is in transition and may need special attention, training, or care to adjust to your home.  Agree to not drop the dog at an undisclosed location, take the dog to any other shelter or rescue, or give the dog away to anyone (even a friend or family member) without notifying Road to Home Rescue Support for approval first  Alert Road to Home if any serious medical or behavior problems arise.  You agree that vetting decisions, including when, where, and how vaccinations, deworming, emergency care, and spay/neuter will be performed, are made only by RTH.  Exercise good judgment and not put the animal in any situation that may cause a person or another animal any harm. Until the animal gets adjusted, it's best to keep over-stimulating experiences such as meeting other animals and lots of people to a minimum.  You agree that the adoption process, including processing and approving applications, collecting adoption fees, and determining the time and place of adoptions, is the responsibility of RTH, with my cooperation.  Foster parents have first priority at adoption and may also make recommendations for adoptions. Foster parents will coordinate with RTH to schedule meets with potential adopters.  You agree to follow all local and state ordinances pertaining to your new dog.  You agree that RTH owns foster animal(s) and has the right to relocate foster(s) if the rescue decides it is in the best interest of the animal or the rescue.  You certify that the above information is true and correct. You understand that any falsification of the above information may be grounds for denial of this application. You acknowledge that this application will remain the property of RTH

Road to Home Rescue Support Agrees To:

 Be available to return any calls about questions or concerns regarding the animal within a reasonable amount of time.  Continue to search for a permanent home for the dog/s.

Foster’s Signature: ______Date: Print Name: Road to Home Signature: ______Date: