Name: Date:

Spouse / Roommate:

Address:

City: State: Zip:

Phone (Home):

Cell Phone:

E-Mail:

Occupation:   

Employer:  

Work Phone:

Spouse’s Occupation:

 Spouse’s Employer:

 Spouse’s Work Phone:

7. Do all appropriate family members agree to this foster program: Yes No

8. Will the foster animals be kept: Indoors: Outdoors: Both:

9. Is anyone in your household allergic to animals? Yes No

10. What other animals do you currently own? # of dogs: # of cats:

11. Give breed, sex, ages and if they have been spayed / neutered for all pets:

12. Please indicate the preventative health measures taken for your pet(s)
Cats:

FVRCP:
FIP:
Rabies:
FELV:
Flea control (type):
Parasite (worm) control:

Dogs:
DHLPP:
Bordetella:
Rabies:
Heartworm preventative (type)
Flea control (type)
Parasite (worm) control:

13. List the names and ages of all children living at home:

14. What kind of animal would you like to foster? Cat : Kitten: Dog: Puppy:

15. Do you have pets that are loose in the house? (Do not include fish, mammals and amphibians, etc. that are in cages.) If so, indicate how many: Cat(s) Kitten(s) Dog(s) Puppy(s) Other:

16. Are you able to keep the foster pet separated from the household pets? Yes No If yes, for how long can you provide separate places for the foster pet(s)?

17. How many hours per day will the foster pet be alone? hrs.

18. Are you prepared to bring the foster pet to: the veterinarian for exam(s), vaccinations, spay or neuter? Yes No

19. Do you agree to give up the foster pet to a permanent home when requested to do so by DAR? Yes No

20. Do you agree to not place the foster pet with anyone other than one that is pre-approved by a DAR representative? Yes No

21 . Do you agree to pay veterinarian bills for procedures you have requested that are not approved by DAR? Yes No

22. Do you agree to hold DAR harmless from infections and diseases to your pet(s) that are spread due to (a) you not keeping the fostered pet separated in the home, and (b) your pet not having adequate preventative health measures?
Yes No

23. Do you agree to notify Dreamland Animal Rescue at least one week in advance of needing to have the fostered pet placed elsewhere? Yes No (exception would be for an emergency on the part of you or your family, or on the part of serious illness of the fostered pet)

24. Do you agree to give your foster pet(s) monthly flea and heartworm preventatives that are provided by DAR? Yes No

25. Do you agree not to use any flea control / preventative or other medication on your foster pet(s) without approval of a DAR representative or a DAR Veterinarian? Yes No

26. I agree all foster pets are to be surrendered to DAR at any time at the request of a DAR representative. Yes No

27. Are you willing to have a DAR representative visit your home? Yes: No :

Answer the following questions if you plan on fostering dog(s) / puppy(s):

1. Have your pets had experience with dogs in the household? Yes: No: Please explain.

2. If the dog needs special care such as getting medicine or baths, are you willing to provide it?
Yes No

3. Do you have a fenced-in yard? Yes No if yes, what type of fence is it?

4. Are you able to walk the dog in the morning and in the early evening? Yes No If no, please explain how you will provide for the dog's bathroom needs.

5. Please describe your experience with handling dogs with respect to both housebreaking and behavioral discipline (such as chewing, loud barking, etc.).


6. Will the fostered dog ever be outdoors unattended? Yes No

7. Are you familiar with crate training? Yes No

8. Are you willing to crate train your foster dog / puppy? Yes No

9. Are you willing to foster a puppy/dog that is not housebroken? Yes No

10. Are you willing to housetrain your foster pet? Yes No

11. Do you agree not to stake, chain, tie-out, or let any foster dog roam loose. Yes No

12. Some foster dogs come from histories of abuse and neglect. DAR requests that the foster dog initially be watched for destructive behavior. If destructive behavior is noticed, there are steps to take such as verbal and physical praise, but only verbal disapproval, etc. Do you agree to isolate or otherwise handle any destructive behavior appropriately without the use of physical discipline? Yes No

13. Do you agree to notify DAR immediately if any destructive behavior is observed? Yes: No:

14. If you choose to work with the dog on its destructive behavior, do you agree to hold DAR harmless from any damages to you or your home that may occur due to fostering the animal. Yes: No:

15. Please check the types of dogs/puppies you are willing to foster:
o Pregnant Dog:
o Nursing mother and puppies:
o Orphan newborns requiring frequent bottle feedings: Do you have experience with this? Yes No
o Puppies not requiring bottle feeding:
o Are you willing to foster puppies until they are at least 12 weeks old? Yes No
o Dog recovering from surgery:
o Dog that has been abused, neglected, or stressed:
o Dog with a physical handicap:
o Dog on daily medication:
o Dog recovering from illness/injury:
o Dog with a behavioral problem (e.g., barking, digging, jumping, etc.):

16. What size dog would you be willing to foster?
o Small under 25 lbs.
o Medium 26-50 lbs.
o Large 51+ lbs

17. Have you ever taken care of a chronically ill dog (e.g., heart or kidney disease, diabetes)? Yes No

18. Are you able to give: Pills: Liquid meds: Injections:

19 . Do you have extra dog supplies (dishes, dog bed, collar/leash, etc)? Yes No

20 . What supplies would you need?

21. Are you familiar with the techniques of introducing another animal into the household? Yes No

22. Are you willing and able to bring the animal to the vet for routine vet care? Yes No

23. Are you willing to talk to prospective adopters about your foster dog? Yes No

Answer the following questions if you plan on fostering cat(s) / kitten(s):

1. Have you ever cared for orphaned newborn kittens? Yes No

2. How many cats or kittens are you able to foster at one time?

3. Are you willing to keep the cat/kittens indoors at all times? (Screened porches are acceptable.) Yes No

4. Are you willing to keep the cat/kitten in foster if it becomes ill with a cold or has to undergo deworming treatment? Yes No

5. Are you willing to keep the cat/kitten in foster if it becomes seriously ill? (DAR will provide medications and veterinary treatments.) Yes No

6. Have all of your cats been tested for Feline Feline leukemia (FeLV)? Yes: No: N/A:

7. Have any of your cats tested positive for Feline leukemia (FeLV)? Yes: No: N/A:

8. Have all of your cats been tested for FIV? (Feline AIDS) Yes: No: N/A:

9. Are any FIV positive? Yes: No: N/A:

10. Have your pets had experience with cats in the household? Yes: No: Please explain:

11. Some foster cats come from histories of abuse and neglect. DAR requests that the foster cat initially be watched for destructive behavior. If destructive behavior is noticed, there are steps to take such as using a spray bottle for clawing, verbal and physical praise, but only verbal disapproval, etc. Do you agree to isolate or otherwise handle any destructive behavior appropriately without the use of physical discipline? Yes No

12. Do you agree to notify DAR immediately if any destructive behavior is observed? Yes: No:

13. If you choose to work with the cat on its destructive behavior, do you agree to hold DAR harmless from any damages to you or your home that may occur due to fostering the animal. Yes: No:

14. Please check the types of cats/kittens you are willing to foster:
o Pregnant Cat:
o Nursing mother and kittens:
o Orphan newborns requiring frequent bottle feedings: Do you have experience with this? Yes: No :
o Kittens not requiring bottle feeding:
o Are you willing to foster kittens until they are at least 12 weeks old? Yes: No:
o Cat that has been abused, neglected, or stressed:
o Cat with a physical handicap:
o Cat on daily medication:
o Cat recovering from illness/injury/surgery:
o Cat with a behavioral problem (e.g., urinating outside the box, biting/scratching)

15. Have you ever taken care of a chronically ill cat (e.g., heart or kidney disease, diabetes)? Yes: No:

16. Are you able to give: Pills: Liquid meds: Injections:

17. Do you have extra cat supplies (litter pan, dishes, cat bed, etc)? Yes: No:

18 . What supplies would you need?

19. Are you familiar with the techniques of introducing another animal into the household? Yes: No:

20. Are you willing and able to bring the animal to the vet for routine vet care? Yes: No:

21. Are you willing to talk to prospective adopters about your foster cat? Yes: No:

By signing (or typing) below:
o I am attesting to the truthfulness of my answers.
o I understand that falsification of any of the above information results in automatic rejection of becoming a foster parent.
o I agree to follow the guidelines set by Dreamland Animal Rescue and to treat my foster pet(s) as if they were my own.
o I agree not to hold DAR or its representatives liable for any damages or injuries the foster animal may cause while in foster care.

Signature:   Date