Name of Animal Fostering Or Type of Animal Willing to Foster:______

H.E.A.R.T. ANIMAL RESCUE, INC.

Foster Application Form

Name of animal fostering or type of animal willing to foster:______

Are you willing to foster an animal with special needs? _____ Yes ______No

Name of Applicant (and spouse/partner if applicable) ______

______

Date of Birth for Applicant ______Date of Birth for Spouse/Partner ______

Physical Address: ______

City/State/Zip: ______

Phone: Home: ______Cell: ______

Email: ______

How long at this address: ______Rent ______Own ______

House ______Apartment ______Condo ______

Does your landlord allow pets? ______Landlords Name: ______

Mailing address if different from above: ______

City/State/Zip: ______

Do you have a yard? ______What size is your yard? ______

What type of fence do you have? ______Height of fence ______

If you do not have a fence and are applying to adopt a dog, how do you plan on exercising the dog and letting them out for the bathroom? ______

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Please list children and ages: ______

Any other occupants in the home please list names and ages: ______

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Are all household members aware of the intent to foster? ______

Have you been arrested for or convicted of animal abuse or neglect? ______

References:

Vet Reference: ______Phone: ______

Address: ______City/State: ______

Account under what name if different than above: ______

Personal Reference: ______Phone: ______

Relationship: ______Alternative Phone: ______

Personal Reference: ______Phone: ______

Relationship: ______Alternative Phone: ______

Current Pets in the home:

Type: (dog/cat, etc.) ______Age ______Sex: ______

Breed: ______Years Owned: ______Spay/Neutered ______

Type: (dog/cat, etc.) ______Age ______Sex: ______

Breed: ______Years Owned: ______Spay/Neutered ______

Are all pets current on Heartworm Prevention: ______If no please explain: ______

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Are all pets current on vaccinations: ______If no please explain: ______

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Where will our animals spend the day? ______

Where will our animals spend the night? ______

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Where will our animas be when you are not home? ______

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On average how many hours a day will the animal be left alone? ______

Please explain what type of training you will do with the dog (clicker training, NILIF, etc.)______

______

Are you willing to crate train? ______YES ______No Explain: ______

Have you ever housetrained a dog? ______YES ______No

Please read carefully and initial each item. You understand by initialing the items below you agree to all terms and authorize us to contact your veterinarian.

______Once an animal is placed in your care you understand they will be there until an approved home is found. This could take months.

______You understand you cannot at any time take or threaten to take a HEART animal to a shelter at any time.

______You understand that once an animal is placed in your care all adoptions go through HEART.

______You understand to be reimbursed through HEART for ANY expense; they must be preapproved by HEART and a valid receipt must be presented.

______You agree to a home visit by HEART.

Email: Facebook: H.E.A.R.T. ANIMAL RESCUE