Name
(Need First and Last):
Street
Address:
(READ:
If you do not live in Michigan, Indiana or Kentucky or live within
25 miles of the state border of one of these states, please do not
continue with this application. We apologize that we're unable to
work with foster homes outside of the aforementioned areas.)
City,
State, Zip:
Home
Phone with Area Code:
Work
Phone with Area Code:
Cell
Number with Area Code:
Preferred
Contact Number:
Home Phone
Work Phone
Cell Phone
May
we contact you at work if needed?
Yes
No
Note:
Your email address below is REQUIRED for this form to be routed to
the Foster Application Team.
Email
Address:
Do
you presently own a Digital Camera?
No
Yes
Do
you presently own any pets?
No
Yes
If
yes, list the name and breed of each pet:
If
you own dog(s), are they all spayed/neutered?
No
Yes
If
no, why not? (Required if you answered "No" above).
What
breed(s) of dogs have you owned in the past?
If
you've owned dogs in the past, please list why they are no longer
with you.
What
did you like or dislike about your past breed of pet(s)? (List for all
previously owned pets).
Are
there children presently living in the house?
No
Yes
If
yes, what are their ages?
What
type of dwelling do you live in?
House
Condo
Apartment
Townhouse
Other
Do
you own the place you live (i.e. home, condo)?
No
Yes
Do
you have permission from your landlord to keep a dog?
No Landlord
No
Yes
If
you have a landlord, please list your landlord's name (whether it
be a company, or a person's name) and phone number, including area
code:
Does
your residence have a yard with a fence?
No
Yes
If
yes, what type of fence?
No Fence
Chain Link
Privacy Fence
Invisible
Other
How
high is the fence?
No Fence
4' or shorter
5' or shorter
6' or taller
Would
you agree to a home visit by a True Heart MinPin Rescue representative?
No
Yes
Have
you ever fostered a dog before?
No
Yes
How
many hours will the dog be alone during the day?
1-3
4-6
7-9
10+
Where
will you keep the dog while you are not at home? (Be specific)
Do
you have a crate to keep the dog in?
No
Yes
Is
there a limit to the length of time you can keep the dog until it gets
adopted?
No
Yes
If
yes, how long can you keep the dog?
If
yes, why is there a limit?
Is
it OK if an interested person comes to your home to look at the dog?
No
Yes
Are
you willing to assume financial responsibility for the everyday care
of the dog (food, shelter, love)?
No
Yes
Are
you willing to take the dog to a vet for spay/neuter, shots, micro-chipping,
etc. (at True Heart MinPin's expense)?
No
Yes
Are
you willing, and able to do preliminary home checks and post-adoption
checks for dogs placed in your area?
No
Yes
Are
you willing, and able to provide telephone support to adoptive families
on training and behavioral issues for dogs you've previously had
in foster?
No
Yes
Limitations
If
limited, please explain:
All
paperwork for placement homes, if processed (i.e. applications, contracts),
must be forwarded to the THMPR Directors within five business days of
completion. Are you able to ensure that this requirement is met?
No
Yes
Please
provide us with a veterinary reference (including area code and phone
number):
Please
provide us with two personal references below - not including relatives
or significant other (include area code and phone number).
List
Name Here (Reference #1):
List
Phone Number Here (Incl. Area Code):
List
Email Address Here (Used ONLY for processing your application in a timely
manner).
Relation/How
do you know this person?
List
Name Here (Reference #2):
List
Phone Number Here (Incl. Area Code):
List
Email Address Here (Used ONLY for processing your application in a timely
manner).
Relation/How
do you know this person?
Please
select your age:
Under 18 years of age
18 - 22 years
23 - 25 years
26 - 29 years
30 - 39 years
40 - 49 years
50 - 59 years
60+ years
How
did you hear about the True Heart MinPin Rescue?
PetFinder
PetSmart Adoption Event
Internet Search Engine
Pets 911
1-800-Save-A-Pet
Friend
Relative
Other
If
other, we'd love to hear where you heard about us:
**PLEASE
MAKE SURE ALL FIELDS ARE FILLED OUT PRIOR TO SUBMITTAL**