Canines for Vets – 2619 East State Street, Hermitage, PA 16148 – 724-346-3818

APPLICATION FOR ENTRY INTO FOSTER TRAINER PROGRAM

IF HANDWRITING, PLEASE PRINT CLEARLY

Date

Name

Address

Phone number Second Phone Number

Email

Is there a certain size / breed / gender you are interested in fostering?

Do you have any breed restrictions?

LIVING ENVIRONMENT:

Do you own?______rent? ______lease?______

Do you plan on moving in the next 6 months? ______1 year? ______

Do you live in a house? _____ Apartment?______Trailer? _____ Condo? ______Duplex? ______

Are you aware of any size, weight or breed restrictions? Yes ____ No ____

If yes, please describe ______

Do you have a fenced in yard? Yes ____ No ____

If yes, how high is your fence? ______

What type of fence? Chain link _____ Privacy _____ Other (describe):______

Is the fence secure / in good condition? ______

Please list any other pets currently residing in the home.

Name Type Age Neutered / Spayed? Up to date on vaccines?

1.

2.

3.

4.

Do you exercise your dog(s)?

How do you do this?

If you walk them, what equipment do you use to walk them on?

Name and phone number of current veterinarian: ______

Do you have dogs or cats that live outside? If so please describe below.

Where do your current dog(s) sleep?

Where do you keep your dog(s) when left alone?

Is your dog(s) social and friendly with other people? ______Dogs? ______

Describe if needed.

Do you have a vehicle to transport foster dog to veterinary appointments, meetings, classes? Yes ___ No____

Are you willing to drive to locations in Hermitage or Hubbard for training? Yes ____ No ____

Are you willing to commit to 3-6 months to foster a dog and follow strict guidelines of training? Yes ___ No __

Are you willing to attend weekly classes AND weekly meetings (this requires a 2-3 night per week commitment – 1 hour per class/meeting)? Yes ____ No ____

Do you have access to the computer / internet? Yes ____ No ____

Have you done training with other dogs before?

If so, where / name of trainer?

Any other comments to add:

Please submit this form via email to

Or you may mail it to:

The Learning Dog

Attention: Jenny Falvey

757 N. Main St.

Hubbard, OH 44425

Please, no phone calls.

This application is not an acceptance of an applicant. The application will be reviewed and if approved for the next level, you will be contacted. Please allow 5-7 business days for review.

By signing this you are stating that the information provided is true. Applicants will be disqualified for misleading or false information. You also understand that this application is not an acceptance of an applicant. The application will be reviewed and if approved for the next level, you will be contacted via phone for an interview (please allow 30 min-1 hour) and then a home visit may be scheduled. Please allow for one hour for a home visit.

Signature: ______Print Name ______

Date: ______

Thank you for your interest in Canines For Vets.

Jenny Falvey, CPDT-KA

(330)534-4990

Canines for Vets Foster Application ©2015 pg. 1