Dog/Puppy Foster Application

Dog/Puppy Foster Application
Thank you for taking the time to fill out this application. Your information will remain confidential and used only as part of the Pugh Zoo Rescue Foster Care Program.
Name, age & occupation of applicant: *
Name, age & occupation of Spouse/Significant Other: *
Names (and ages) of children or other occupants in the home, if any : *

Address *

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

County and/or Township *
Cell Phone *
Home Phone
Work Phone
E-mail *
How did you hear about us?
HOUSEHOLD INFORMATION:
How many people are in your household? *
Do you live in a: *
Other, please specify below:
How long have you been at this address? *
Do you: *

Own Rent
If renting/leasing, are there pet restrictions? *

Yes No Not Applicable
If yes, what are they?
If you rent, do you have your landlord’s permission to foster a dog? *

Yes No Not Applicable
If renting, we will contact your landlord to ask if fostering animals in your home is acceptable. You will not be able to foster until we receive positive confirmation
Landlord’s Name and Phone Number
Does anyone in the household have allergies?

Yes No
If so, what kind?
Does anyone in the household smoke?

Yes No
If so (check all that apply)...

Inisde the home Outside the home ONLY outside the home
Has anyone in the household ever been charged or convicted of animal cruelty or abuse? *
On an average day how much of the time will the dog be outdoors? *
PZR foster dogs and puppies must be supervised at all times when outdoors.
When outside, how do you plan to keep your foster dog? Check all that apply: *

Tie out chain or cable Patio or deck area Garage Outside dog run Invisible or wireless fence Loose in yard unattended Leashed and regular walks Fenced yard
Do you have a fenced yard? *

Yes No
If so, how high is the fence?
Type of fence:
Are the gate(s) normally locked?

Yes No
Do you have a pool? *

Yes No
If so, is it fenced separately from the yard?

Yes No
On an average day how much of the time will the foster dog be indoors? *
When inside, how do you plan to keep your foster dog when you are home: *

Free inside home Confined to a crate Inside a closed room
About what percentage of the time will the foster dog be left alone? *
Where will the foster dog stay when left alone? *
What areas of the house will the foster dog be allowed into? *
Where will the foster dog sleep at night? *
How would you describe your level of experience with dogs? (check all that apply) *

Never had a dog Had childhood pet dog Had one or more as an adult Have experience with powerful breeds Have experience working with on-going medical problems with a personal dog Have experience working at a boarding kennel/resort/pet sitting service etc. Have experience working with behavioral problems with a personal dog Have experience working in a veterinary hospital Am a professional dog trainer Have previous foster/rescue experience. Describe below:
Do you have experience with: *

Small Breeds Medium Breeds Large Breeds
List experience with specific breeds: *
What types of dog do you wish to give a loving foster home to? (check all that apply) *

Friendly dog Senior dog Dog that needs training Dog with special needs Shy or timid dog High-energy dog Physically challenged or handicapped dog Adult Dog Puppies Mother with nursing puppies Unweaned puppies/Bottle babies Sick dog/puppy Injured dog/puppy Dog/puppy with behavioral issues Long-term hospice care
What situations do you feel unprepared for?(check all that apply) *

Excessive barking Destructive chewing Not housetrained Digging Escaping Resource (food/toy) guarding/aggression Shy, fearful, or undersocialized dog Not good with children Not good with other dogs Not good with small animals/cats Scratching/biting Administering medications Providing on-going training Very high activity level Deaf/Blind dogs Option16
Other pets you currently have (specify number of each):
Dogs
Cats
Other
Dog/Cat ----Breed----Name--- Age-----M/F------Altered?-----How long owned? *
We recommend all other animals in your home be up to date on vaccinations and must be spayed/neutered. If you have any concerns, please discuss the idea of fostering animals with your veterinarian.
What happened to the ones you no longer have? *
Do you have a preference on...
Size? *
Breed? *
Age? *
Do you have a regular veterinarian? *

Yes No
If so, name of Vet or Clinic:

Vet's Address

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

Vet's Phone Number

Area Code Phone Number
Please tell us anything else you would like us to know to help match you up with the right foster animal: *
Name of Personal Reference #1: *
Telephone # : *
Name of Personal Reference #2: *
Telephone # : *
Please read the following carefully and initial after each paragraph:
PZR determines the criteria for fostering, decides which animals are eligible for foster care, and appoints foster caregivers from a pre-approved list of trained providers. PZR will require you to fill out a foster application and a Pugh Zoo Rescue Pet Foster Care Agreement prior to being accepted as a foster parent. PZR foster care volunteers may always refuse any specific request for any reason. PZR staff will inform you of any medical treatments to be administered, the anticipated length of the foster-care period, the objectives of each particular placement (restoring to health, rearing to adoptable age, socialization, etc.), and any other restrictions or expectations we may have. *
You will be expected to keep the animal safe and secure, return it to PZR when requested to do so, and not promise the animal to anyone, or imply that you have the authority to approve a potential adoption. PZR retains ownership of all animals placed in foster care, and will make all decisions regarding the adoption & placement of the animals fostered. PZR cannot accommodate people fulfilling court-ordered community service within the Foster Care Program. PZR does not accept into this program those convicted of violent crimes or crimes involving animal cruelty or neglect. *
Unless otherwise arranged, the foster parent is responsible for providing all food, litter, bedding, and toys for the animal while it is in their care at home. The foster parent is responsible for transporting the animals to and from veterinary appointments, surgery, behavior evaluations, vaccinations, etc., The foster parent may also be responsible for transporting the animal to and from adoption events, and to off-site training classes, at the Foster Care Coordinator’s discretion. Upon return your foster animal to PZR you will be required to fill out a brief questionnaire about your foster animal’s behavior and personality. *
I have read and understand the statements above. I certify that all the information contained in this application is true and correct. I understand that although PZR takes reasonable care to screen animals for foster care placement, it makes no guarantees relating to the animals’ health, behavior or actions. I understand that I receive foster care animals at my own risk and can decline to accept any animal for which PZR has asked me to provide care. I acknowledge that PZR is not responsible for any property damage or personal injury suffered by me, members of my household, including my own animals, or any third parties during a foster placement, and I assume liability to provide adequate controls to prevent such damage or injury.
Signature: *
Date:
Should be Empty: