/ Denver Samoyed Rescue
Foster Home Application

Thank you for volunteering your heart and home to a rescued Samoyed. The information you provide here helps us match each Samoyed to the best prospective foster home. Please complete both pages and either mail to the address indicated, or return in person to a DSR volunteer. And again, Thank you for caring!

Name: / Date:
Marital Status: / Married / Single
Spouse’s Name:
Address: / City / State / Zip+4
How long at current address?
Telephone Number(s): / Home / Work / Fax
E-Mail Address:
Who is your employer?
Occupation:
Spouse’s Employer / Work Phone Number:
Spouse’s Occupation:
How did you hear about Denver Samoyed Rescue?
Number and ages of children living in household:
Number of adults in household over age 18:
Are all family members willing to care for a foster dog?
If not, please explain
What type of area do you live in? / City / Suburb / Rural
What type of housing? / Apt. / Condo / Duplex / House / Other
Do you rent or own your home? / Own / Rent
If you rent or lease, do you have permission from your landlord:
To own a dog? / Yes / No
To own a samoyed? / Yes / No
Do you have a fenced yard? / Yes / No / Height of Fence
Type of fence: / Chain Link / Wood / Other/describe:
If you don’t have a fenced yard, where and how will the dog be exercised and be allowed to eliminate?
What other pets do you now have or have you previously owned?
Please list which pets you still own and what happened to those who no longer live with you
Have you ever used a dog crate? / Yes / No
Do own a dog crate?
How will you transport your foster dog? (car, van, pickup, etc.)
Why do you want to become a foster home?
What do you know about Samoyeds as a breed?
Have you had any previous experience with Samoyeds? / Yes / No
If so, please explain
All of our dogs are surgically altered (spayed or neutered) before they enter a foster home environment to prevent further over population of the breed. With this understanting, do you have a preference as to the sex of your foster dog?
Male / Female / Either
Have you ever surrendered a pet of yours to an animal shelter or sold or given one away? / Yes / No
If yes, why?
Are you willing to foster a dog that has special medical and/or physical needs? For example, arthritis or a thyroid condition
Yes / No
Does your home have stairs? / Yes / No
If so, how many and where are they located?
It is crucial that our foster dogs are made available to be seen by the general public so that they have every opportunity to be adopted. With this understanding, do you agree to have the rescue dog available for viewing by potential new owners?
Yes / No
If no, please explain

Any and all dogs that you foster must be placed through DSR. It will not be acceptable for you to act on your own to place a rescue dog that you are fostering. However, your help to find potential adoptive families would be greatly appreciated. These potential adoptive families must complete a “DSR Application for Adoption”, be interviewed by a DSR volunteer and, if acceptable, the rescue dogs must be placed through DSR.

PLEASE NOTE: Denver Samoyed Rescue is subject to the rules and regulations of the state of Colorado, Department of Agriculture, Pet Animal Care Facilities Act (referred to as PACFA). Foster care givers must be willing to allow a PACFA/DSR representative to inspect their property upon request.

Applicant Signature / Date / DSR Witness / Date

After completing both pages of this application, please return it to the address below, or give it to a DSR representative. Someone representing DSR will notify you of your status as a Samoyed Rescue foster home.

Denver Samoyed Rescue

PO Box 134

Lafayette, CO 80026-0134

720-381-6808 (fax)

We reserve the right to refuse any applicant.

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DSR_FosterApp 11/21/09