POBox 46

Pt. Pleasant,PA 18950

E-Mail:

Foster Application

Personal Information

Name: ______DOB (Year Only) ______

Email Address: ______

Day Phone: ______Evening Phone: ______

Cell Phone: ______

Address: ______

City: ______State: ______Zip Code ______

When are you available to start fostering? ______

References

Please provide the contact information for two (2) personal references (non-family members)

1)  Name + Phone:

Relationship:

2)  Name + Phone:

Relationship:

Please provide the name of Current or primary Veterinarian.

Name:______

Address/Phone:______

Employment

Occupation: ______

Employer: ______

Phone______

Address______

Spouse’s Occupation: ______

Spouse’s Employer: ______

Phone______

Address______

Household Information

How long have you lived at your current Address ?______

Own?______Rent?______

Do you plan on moving in the near future? ______If so why? ______

If you rent:

Landlord’s name: ______

Phone: ______

Is this a multi-unit rental? ______

Do you have your landlord’s permission to have a dog? ______

If so, up to what size? ______

Names of people who live in your residence:

Name / Age

Are any of the people in your residence allergic to dogs? ______

Are your children afraid of dogs? ______

Do you have other children that visit you? ______

If so, how often? ______

Have you ever owned an animal before? ______

If deceased, please provide details. ______

______

Names of animals that currently live in your household:

Name… Dog or Cat / Breed & Age / Spayed/Neutered

Please tell us the following about your current pet(s) personality to best match our foster dog to your family (ie: submissive, playful, bossy)

______

Foster Information

Have you ever fostered before?______How long ago? ______

Why are you interested in fostering a dog? ______

______

Do you have any special criteria for a foster dog that would live at your residence? (sex, age, size, breed, activity level, etc.)

______

Please tell us your dog experience; Please describe your experience with:

Housetraining:______

Crate Training:______

Obedience Training: ______

Socialization Training: ______

Anything else you would like us to know to help determine a match for you:

______

______

Have you ever experienced dogs that did not get along?

______

If so, how did you handle the situation?______

If your other animals do not get along with your foster dog do you have a way to separate them when you are not at home?______

Do you have a fenced in area on your property? ______

Is the area completely fenced in? ______

If so: The fence is ______ft high and the inside area is ______ft

What type of fence do you have? ______

If you have no fence, how do you plan to have your new dog relieve/exercise itself? ______

How active is your lifestyle aside from work? Please explain: ______

Do all adults in the household work fulltime? ______

How many hours each day will your foster dog be alone? ______

Where will the dog stay when alone? ______

Are you agreeable to having a home-check done prior to fostering? ______

Would you be willing to foster a heartworm positive dog? ______

Anything else you want to add? ______

I understand that there is always an adjustment period for any foster dog coming into my home. The Average time a dog spends in a foster home is 2 to 5 weeks and I am willing to work to make this foster dog a member of my family during his/ her stay. I understand that many of these dogs have survived tremendous odds and need lots of TLC. I understand that Lulu’s Rescue cannot be held responsible for the actions, behaviors and/or medical condition of all dogs in its rescue. I agree to assume the risks implicit in working with dogs who may have been abandoned, beaten, or otherwise mistreated or abused, or who may suffer from an illness, condition or disease. Although Lulu’s Rescue evaluates dogs prior to accepting them into its rescue, they cannot guarantee the temperament of any of the dogs since most of their histories are unknown. ______(initial)

I understand that Lulu’s advocates crate training each dog and I agree to this and will be given a crate on loan to use if I do not have one. ______(initials)

During the first two weeks of fostering my dog, I understand that Lulu’s asks that I begin a regimented crate training routine, with breaks for mealtimes, potty times, exercise times and supervised playtimes. This regimented schedule will help your foster to acclimate to their new surroundings, will help with potty training, and will help keep them safe while they learn their new routine. ______(initials)

I have received and reviewed a copy of the Foster 101. I have received and reviewed the article called Two Weeks and understand the importance of the first two weeks in my house and the effect of trigger stacking in my foster dog’s new environment. ______(initials)

I understand that Lulu’s has access to volunteers, behaviorists, and trainers that can assist me in helping my foster dog become more adoptable and I will reach out to them immediately should the need arise. ______(initials)

I understand my foster must be kept on a leash AT ALL TIMES when in an unfenced or unenclosed area….even when hiking, or just walking from my house to the car. All rescues are prone to being escape artists, especially in a new environment or when left alone. They may bolt out of an open front door. I will be aware and be careful. ______(initial)

I understand that Lulu’s Rescue reserves the right to check on the welfare of this dog on my premises, and to reclaim both possession and ownership without payment of any kind. In the event that I do not comply with the foster guidelines and Lulu’s Rescue reclaims any foster dog from me, I waive claim to trespasser. ______(initial)

I understand that Lulu’s Rescue must approve all adoption applications, so I will not promise anyone that they can adopt my foster. Of course Lulu’s Rescue will be happy to receive adoption referrals and recommendations. If you are considering adopting your foster yourself, Lulu’s Rescue would discuss any serious applications with you before placing the dog in another home. The adoption fee is non negotiable. ______(initial)

I understand that Lulu’s Rescue will be responsible for approved medical expenses that may occur while the dog is in my foster care. If a veterinary visit is necessary, please contact your foster coordinator as vet visits must be made by Lulu’s Rescue at our approved veterinarian. ______(initial)

If you have a concern about a foster dog having a medical issue, please contact us immediately. We must approve any care with the exception of a life threatening emergency. ______(initials)

We greatly appreciate your interest in participating in our foster program. In the unlikely event anyissue (s)should arise related to your participation in the foster program or this Agreement, you agree that any dispute shall be subject to the laws of the Commonwealth of Pennsylvania and the exclusive jurisdiction of the courts of Bucks County Pennsylvania. ______(initial)

I have read the application and program description on this form in its entirety and understand the risks involved in working with these dogs. I also agree that if the information given on this application is not accurate to the best of my knowledge, I forfeit all rights to any and all foster dogs residing in my care.

This is a legally binding contract.

I agree that all statements I have made on this form are true. If it is found that any statements I have made on this form are not true, the adopted animal can be confiscated.

Foster’s Name (print): ______

Foster’s Signature: ______
Date: ______