Personal Information
Name:
Address:
City:
Province:
Postal
Code:
Phone
(Day):
Phone
(Evening):
eMail
Address:
Alternate eMail:
Number
of adults in household:
Number
of children in household:
Employer's Address:
Employer's City:
Employer's Province:
Employer's Postal Code:
Employer's
Company Name:
Days &
hours you work outside the home?
Own or
rent dwelling?
Own
Rent
Type
of dwelling you live in?
If
renting, do you have landlord's permission to keep a dog?
Yes
No
Not
Applicable
If you
live in a strata complex, are you aware of the strata rules
regarding dogs and do you have a copy of the strata agreement?
Yes
No
Not
Applicable
Would
you be willing to allow us to visit your home?
Yes
No
Environmental Information
How
large is your yard?
Is it
securely fenced?
Yes
No
If
yes, what kind of fence?
How
tall is the fence?
If the
yard is not fenced, how do you plan to ensure that the dog gets safe
and adequate exercise?
Where
will the dog sleep at night?
Where
will it be during the day when you are at home?
When
you are not at home?
Do you
plan to use a crate?
Yes
No
Why,
or why not?
How
many hours a day will the dog be alone?
Where
will the dog stay when alone?
If
needed, can you isolate the dog?
Yes
No
If
yes, where will you isolate the dog?
Your Pets
Have
you ever owned a dog before?
Yes
No
If
yes, how many?
For
how long?
Where
did you get your dogs?
What
happened, in detail, to your previous dog(s)?
Do you
have any other pets at this time?
Yes
No
What
kind, age & sex?
Are
your current animals spayed or neutered?
Yes
No
If you
have other animals, what has been your main health and/or behaviour
experience?
How do
you think your other pets would react to a rescue dog?
Foster Preferences
Are
you willing to foster a dog for a short period of time or until the
dog is placed?
Short
Period
Until
Placed
What
type of dogs will you take, or not take? (eg. only males, only
females, only older dogs, only medium sized, only long coated, etc)
In an
emergency, would you be willing to take a dog that did not fit your
criteria?
Yes
No
What
medical considerations will you make in taking a rescue dog? (eg.
won't take a dog diagnosed with heart worms, etc)
Will
you do any training with the foster dog while in your care?
Yes
No
What
type of training and how much?
What
is your definition of disciplining a dog?
How
will you deal with behaviour problems in a rescue? (eg. aggression,
urination, etc)
Tough Decisions
Would
you be able to handle the emotions resulting from dog needing
to be euthanized due to an illness after it was placed with you?
Yes
No
Comments?
What
are your thoughts on having a dog euthanized due to temperament
problems?
How
would you handle a situation in which a rescue dog bit you?
Or bit
someone else?
Have
you emotionally prepared yourself for the sadness that comes when
the dog is placed in a permanent home?
Yes
No
Comments?
Please
describe your experiences with obedience classes?
References
Reference 1: Name
Address:
City:
Province:
Postal
Code:
Phone
(Day):
Phone
(Evening):
Reference 2: Name
Address:
City:
Province:
Postal
Code:
Phone
(Day):
Phone
(Evening):
I, the undersigned, attest, to the best of my
knowledge, the above information is accurate and complete at the
time of signing, and I understand that falsely provided information
can mean that my application will be terminated.
Signature:
Date:
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