Form

Pacific Pug Rescue Foster Application

(Our foster homes are located in the Portland/Vancouver Area)
Full Name

First Name Middle Name Last Name
Spouse/Partner

First Name Middle Name Last Name
Cell Phone

- Area Code Phone Number
Home Phone

- Area Code Phone Number
E-mail

Current Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Do you own or rent your home?

Own Rent
How long have you lived at your current address?
If you rent, please provide:
Landlord Name:

First Name Last Name
Landlord Phone:

- Area Code Phone Number

Employment History

Employer
What are your hours and okay to contact you there?
How Long Employed	Work Phone
Postal / Zip Code	Country

Spouse/Partner Employer
What are your hours and okay to contact you there?
Work Phone	Work Phone
Postal / Zip Code	Country

What are the ages of any children living in your home?
Is anyone in your household allergic to dogs?

Yes No
Is everyone in the family in favor of fostering a Pug?

Yes No
Please tell us why you have decided to foster:
Pet History
List all pets currently residing in your home and their ages.
Do any of your animals have any physical problems?

Yes No
If so, please describe
Are any of your pets currently under treatment or taking medications?

Yes No
Are they spayed or neutered?

Yes No
Are all pets up to date on vaccines?

Yes No
Do your animals get along with other dogs?

Yes No
Have you fostered any animals in the past?

Yes No
Have you ever owned or fostered a Pug?

Yes No
How have you educated yourself about this breed of dog?
Please list your regular Veterinarian/Vet Clinic
Veterinarian Phone

- Area Code Phone Number
What age of foster will work best in your home?

Puppy Adult Senior No Preference
Sex

Male Female No Preference
Where will you keep your foster:
During the day?
At night?
If you are away from home overnight?
Do you have a fenced yard?

Yes No
Kind of fencing and height?
If you do not have a fenced yard, how will you:
Exercise the dog?
Provide for their need to eliminate?
What is the maximum number of hours your dog will be left alone during a 24 hour period?
Where will he/she spend this time?
Do you object to the appropriate use of a crate?

No Yes
What will you do if your foster is destructive when left alone?
How would you handle problem behavior (aggression, excessive barking, marking)?
Have you ever surrendered to an animal shelter or sold any of your pets?

Yes No
If yes, please explain the circumstances:
Have you ever trained a dog before?

No Yes
If yes, please describe
Are you willing to house train a foster?

Yes No
Are you willing to foster a special needs Pug?

Yes No
Can you administer medications?

Yes No
How would you introduce a foster dog to your family and current pets?
Has anyone in your immediate family/household ever been convicted of a charge related to cruelty to animals or child abuse?

Yes No
Have you ever volunteered for any organization fostering animals?

Yes No
If so, please list organization and describe responsibilities:
Please provide the names, email addresses, and phone numbers of two non-related individuals (not living with you) who can serve as references:
Reference #1 *

First Name Last Name
E-mail *
Phone Number *

- Area Code Phone Number
Reference #2 *

First Name Last Name
E-mail *
Phone Number *

- Area Code Phone Number
Are you able to transport your foster to: Veterinarian appointments? Monthly “Outreach” Events? To prospective adoptive homes for preadoption “Meet ‘N Greet”?

Yes No
I understand that there is a possibility of health or injury risk to humans and personal pets when caring for Pacific Pug Rescues foster animals. I will not hold Pacific Pug Rescue liable for any injury or illness that may result from my foster activities.
I understand that there is a risk of damage personal property when caring for Pacific Pug Rescues foster animals. I will not hold Pacific Pug Rescue liable for any damage to personal property that may result from my foster activities.
Thank you for taking your time to complete this application. By signing below you attest to the truthfulness of your answers and give permission for a Pacific Pug Rescue Volunteer to verify any of the above.

If there are two responsible adults in household, both must sign as an applicant.
Applicant Signature

First Name Last Name
Applicant Signature

First Name Last Name
"Signed"

- Month - Day Year
at
: Hour Minutes
Should be Empty:

Pacific Pug Rescue Foster Application

Pet History

I understand that there is a possibility of health or injury risk to humans and personal pets when caring for Pacific Pug Rescues foster animals. I will not hold Pacific Pug Rescue liable for any injury or illness that may result from my foster activities.

I understand that there is a risk of damage personal property when caring for Pacific Pug Rescues foster animals. I will not hold Pacific Pug Rescue liable for any damage to personal property that may result from my foster activities.

Thank you for taking your time to complete this application. By signing below you attest to the truthfulness of your answers and give permission for a Pacific Pug Rescue Volunteer to verify any of the above.