Dog Foster Application

Foster

"*" indicates required fields

1Applicant

2Family

3Home

4Care

5Preferences

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Default Status

First Name*

Last Name*

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Age Range*

eMail Address*

eMail Address Confirm eMail Address

Street Address*

Suite | Apt or Unit Number

City*

State/Province*

ZIP*

Country*

Home Phone Number

Work Phone Number

Cell Phone Number*

Eleventh Hour Rescue requires applicants to be at least 23 years old to foster a dog. Proof of age will be required prior to any any foster being placed. Do you fully understand this policy?*

Yes

Date of Birth*

MM slash DD slash YYYY

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Preferred Method of Contact*

Employment & Schooling

Are You Employed?*

Yes

Retired

Full or Part Time?*

Name of Employer*

How Long Employed There?

Are You In School?*

Yes

Full or Part Time?*

How Did You Hear About Us?*

What Is Your Friend's Name?*

Which Shelter?*

Which Rescue?*

Please Describe*

Below are three areas for information on other members of your family. Please include all other adults, children and pets living in your home by clicking on the designated button.

Adults

Are There Other Adults In The Home? (18+)*

Yes

Have all adult household members agreed upon fostering an animal?*

Yes

How Many?*

Adult 1

First Name*

Last Name*

Date of Birth*

MM slash DD slash YYYY

Gender*

Relationship To Applicant*

Please Describe*

Phone Number*

eMail Address*

Are They Employed?*

Yes

Retired

Full or Part Time?*

Name of Employer*

How Long Employed There?*

Are They In School?*

Yes

Full or Part Time?*

Adult 2

First Name*

Last Name*

Age Range*

Date of Birth*

MM slash DD slash YYYY

Gender*

Relationship To Applicant*

Please Describe*

Phone Number*

eMail Address*

Are They Employed?*

Yes

Retired

Full or Part Time?*

Name of Employer*

How Long Employed There?*

Are They In School?*

Yes

Full or Part Time?*

Adult 3

First Name*

Last Name*

Age Range*

Date of Birth*

MM slash DD slash YYYY

Gender*

Relationship To Applicant*

Please Describe*

Phone Number*

eMail Address*

Are They Employed?*

Yes

Retired

Full or Part Time?*

Name of Employer*

How Long Employed There?*

Are You In School?*

Yes

Full or Part Time?*

Adult 4

First Name*

Last Name*

Age Range*

Date of Birth*

MM slash DD slash YYYY

Gender*

Relationship To Applicant*

Please Describe*

Phone Number*

eMail Address*

Are They Employed?*

Yes

Retired

Full or Part Time?*

Name of Employer*

How Long Employed There?*

Are They In School?*

Yes

Do You Now or Have You Ever Had a Dog?*

Yes

How Many?*

Have you ever taken care of a dog before (ie fostering, dog walker, dog sitter, etc) or have any other dog experience?*

Please provide details, including the rescue organization’s name & contact info:*

Please Describe*

Dog 1

Dog's Name*

Where Did You Get The Dog?*

Please Explain*

Is Dog Still Living With You?*

Yes

Which Years Owned*

How Long Did You Own Him/Her?*

Why not?*

Why was dog euthanized?*

Please describe the situation please explain the circumstances and what the outcome was for the pet.*

Please Describe The Situation:*

Please Describe*

Breed*

Age Range*

Gender*

Status*

Please Explain Why Not*

Sociability*

Sleeping Quarters*

Up To Date on All Vaccines?*

Yes

Vaccinated Annually?*

Yes

Up To Date on Heartworm Prevention for Every Season?*

Yes

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Is There Any Additional Information You Would Like to Add?*

Dog 2

Dog's Name*

Where Did You Get The Dog?*

Please Explain*

Is Dog Still Living With You?*

Yes

Which Years Owned*

How Long Did You Own Him/Her?*

Why not?*

Why was dog euthanized?*

Please describe the situation please explain the circumstances and what the outcome was for the pet.*

Please Describe The Situation:*

Please Describe*

Breed*

Age Range*

Gender*

Status*

Please Explain Why Not*

Sociability*

Sleeping Quarters*

Up To Date on All Vaccines?*

Yes

Vaccinated Annually?*

Yes

Up To Date on Heartworm Prevention for Every Season?*

Yes

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Is There Any Additional Information You Would Like to Add?*

Dog 3

Dog's Name*

Where Did You Get The Dog?*

Please Explain*

Is Dog Still Living With You?*

Yes

Which Years Owned*

How Long Did You Own Him/Her?*

Why not?*

Why was dog euthanized?*

Please describe the situation please explain the circumstances and what the outcome was for the pet.*

Please Describe The Situation:*

Please Describe*

Breed*

Age Range*

Gender*

Status*

Please Explain Why Not*

Sociability*

Sleeping Quarters*

Up To Date on All Vaccines?*

Yes

Vaccinated Annually?*

Yes

Up To Date on Heartworm Prevention for Every Season?*

Yes

This field is hidden when viewing the form

Is There Any Additional Information You Would Like to Add?*

Dog 4

Dog's Name*

Where Did You Get The Dog?*

Please Explain*

Is Dog Still Living With You?*

Yes

Which Years Owned*

How Long Did You Own Him/Her?*

Why not?*

Why was dog euthanized?*

This field is hidden when viewing the form

Please describe the situation please explain the circumstances and what the outcome was for the pet.*

Please Describe The Situation:*

Please Describe*

Breed*

Age Range*

Gender*

Status*

Please Explain Why Not*

Sociability*

Sleeping Quarters*

Up To Date on All Vaccines?*

Yes

Vaccinated Annually?*

Yes

Up To Date on Heartworm Prevention for Every Season?*

Yes

Is There Any Additional Information You Would Like to Add?*

Other Pets

Are There Other Pets In The Home?*

Yes

Are your current pets receptive to new pet additions in the home?*

Yes

I don't know

Not applicable

How Many?*

Other Pet 1

Animal Type*

Pet's Name*

Sleeping Quarters*

Sociability*

Other Pet 2

Animal Type*

Pet's Name*

Sleeping Quarters*

Sociability*

Other Pet 3

Animal Type*

Pet's Name*

Sleeping Quarters*

Sociability*

Other Pet 4

Animal Type*

Pet's Name*

Sleeping Quarters*

Sociability*

Additional Information

Is there any other additional information you would like to add about your family or current/previous animals?

Residence Information

Type of Residence*

Provide contact info for HOA or Property Management Company*

Please Describe Type of Residence*

How long have you been living at your current address?*

Do you have any plans to relocate from your current residence within the next 6 months?*

Yes

When?*

Do You Own or Rent?*

Is your name, as it appears on this application, the name on your deed ?*

Yes

Please provide name and contact information.*

Is your name, as it appears on this application, the name on your lease ?*

Yes

Please provide name and contact information.*

Does Landlord Allow Dogs?*

Yes

Are There Any Breed Or Size Restrictions?*

Yes

Please Tell Us The Breed Or Size Restrictions*

Please Provide Landlord's Name*

Please Provide Landlord's Phone Number*

Are they the documented owner of the property?*

Yes

Please provide their name(s) and contact information (email & phone number)*

Please provide their email address*

Please provide their phone number*

Please explain the living situation*

Yard Information

Do You Have A Yard?*

Yes

Is The Yard Fenced?*

Yes

What Material Is The Fence Made From?*

Please Describe Fence Material*

How High Is The Fence?*

What Is The Lowest Point of The Fence?*

Do You Have A Pool?*

Yes

Will Dog Have Access To The Pool Area?*

Yes

How Will You Manage Safety?*

Family & History

What Type Of Household Do You Have?*

Please Describe*

Is Any Member Of Your Household Allergic To Dogs?*

Yes

Other

How is this managed?*

Please Describe*

Feeding & Exercise

Who Will Be Responsible For Feeding The Dog?*

Do You Plan on Walking The Dog Daily?*

Yes

Who Will Be Responsible For Walking The Dog?*

What Other Means of Exercise Do You Plan On Providing the Dog?*

Sleep & Alone Time

Where Will The Dog Sleep?*

Where Will The Dog Be When Alone?*

Please Describe Where The Dog Will Be*

Do You Have A Doggie Door?*

Yes

Is It Locked When You Are Away From Home?*

Yes

If You Are Gone From Home During The Day, Does Someone Let Your Dogs Out?*

Yes

What is The Longest Time The Dog Will Be Alone (without humans)?*

Do you understand that if you are going on vacation, you will need to arrange for your dog to go to an official EHR vacation foster or the kennel for the duration of your stay*

Yes

Behavior & Training

Dogs Can Take A Month Or Longer To Adjust To A New Home, Particularly If Other Pets Are Involved. Are You WIlling To Devote This Much Time To Make The Dog Comfortable In Your Home?*

Yes

What Behaviors Can You Tolerate (AND WORK ON)?

Needs Social Skills*

Accidents In The House*

Inappropriate Chewing*

Excessive Barking*

Digging*

Separation Anxiety*

Other

Yes

Please Explain Other Behaviors You Cannot Tolerate and How You Might Work With The Dog To Train Them For These Behaviors.*

Personal References

Please provide three (3) personal references who can speak on your ability to be an adequate foster. One (1) reference may be a family member not living in the same home. Each other reference must be of non-family relation, such as a co-worker, neighbor or friend.

Reference #1

Please Provide Reference's First Name*

Please Provide Reference's Last Name*

Please Provide Reference's Phone Number*

Please Provide Reference's eMail Address*

Relationship To Applicant*

Years Acquainted*

Reference #2

Please Provide Reference's First Name*

Please Provide Reference's Last Name*

Please Provide Reference's Phone Number*

Please Provide Reference's eMail Address*

Relationship To Applicant*

Years Acquainted*

Reference #3

Please Provide Reference's First Name*

Please Provide Reference's Last Name*

Please Provide Reference's Phone Number*

Please Provide Reference's eMail Address*

Relationship To Applicant*

Years Acquainted*

Veterinarian Information

Have You Used A Veterinarian Before? (Please contact them and give permission to release information to The 11th Hour Animal Rescue Inc.)*

Yes

Please Provide Veterinarian's Name*

Please Provide Name of Animal That Was Seen BY This Vet*

Please Provide Veterinarian's Phone Number*

Please Provide Veterinarian's Address*

If you have taken your animals to more than one veterinarian in the last 5 years, please list each additional veterinarian (name, city, state and phone number)" requires an answer even if the answer is not applicable

Foster Care

For how long are you willing to foster a dog?*

Which of the following best describes your reason for fostering?*

Do you understand that the Rescue requires that all fosters read our “Foster Manual”, which will be provided to new fosters once approved, in its entirety and follow the policies and protocols outlined in the manual?*

Yes

Do you understand that while the Rescue makes every effort to provide only accurate information about a dog, rescue cannot guarantee the breed, age, full-grown size, medical status, history, behavior, or temperament of any animal?*

Yes

Do you understand the importance of letting a dog decompress for the first 30 days in a new home and that you should have minimal visitors during this time?*

Yes

Do you understand that the foster dog is the property of the Rescue and can be removed from the foster family by the Rescue or their representatives at any time and without prior notice?*

Yes

Do you understand that no decisions may be made regarding veterinary care (including euthanasia,) or placement without the prior approval of the Rescue?*

Yes

Do you undertand that the Rescue requires that fosters bring their foster animal to be showcased at one of our adoption centers or adoption events at least twice per month (if the temperament of the animal allows).*

Yes

Do you understand that if the foster family finds it can no longer keep the dog in their care, they shall notify the Rescue immediately to arrange returning the dog?*

Yes

Do you understand that in the event the foster family wishes to permanently adopt the rescue in their care, an Adoption Application must be filed and, if approved, an Adoption Placement Contract must be signed?*

Yes

Would You Consider:

Select all that apply.

Two Dogs that are considered a bonded pair?*

A Pregnant Dog*

Are you willing and able to foster a pregnant mama dog through her pregnancy and keep her and her puppies until they are ready for adoption at around 2 months of age?*

Fostering Bottle Babies*

An Entire Litter Of Puppies?*

A Dog who love all humans but who CANNOT live with, be around, or socialize with other dogs?*

A Dog who love all humans and socializes with other dogs, but must be the only dog in the home?*

A Dog who that does not do well with strangers and therefore, would need to be put away when you have guests in the home?*

A Dog who has been living at our shelter for over a year, understanding that the dog will need patience and some level of behavioral rehabilitation?*

A Dog That Is Not Good With Younger Children (under 10)?*

A Dog That Needs Medications?*

A Dog That Has a Serious Health Condition?*

Please Select All Health Condition(s) You Would Accept:*

A Dog who is a hospice situation, meaning one that is terminally ill?*

A Dog Who Needs Training For A Behavior Issue?*

Please Select All Behavior Issue(s) You Would Accept*

A Dog That Has Special Needs?*

Please Select All Special Needs(s) You Would Accept:*

Select All That Apply

A Dog That is Not Completely Housebroken?*

Select Gender*

Select Adult Size Preference (select all that apply)*

Select All That Apply

Select Age Preference*

Select All That Apply

Are you fully prepared to handle the following puppy needs and behaviors, which include, house-training, crate-training, potty outside every two (2) hours, accidents in the home, chewing, barking, mouthiness, crying at night, high energy level, etc.? Do you understand that all puppies require consistent training and socialization in order to become a well-balanced and well-behaved dog?*

Please describe your experience with very young puppies:*

Are you fully prepared to handle the following puppy needs and behaviors, which include, house-training, crate-training, potty outside every two (3-4) hours, accidents in the home, chewing, barking, mouthiness, crying at night, high energy level, etc.? Do you understand that all puppies require consistent training and socialization in order to become a well-balanced and well-behaved dog?*

Please describe your experience with puppies:*

Select Temperament Preferences*

Select All That Apply

Do You Have Breed Preferences?

Yes

(Note: The majority of the Rescue dogs are mixed breeds, and the breeds listed are mostly best guesses based on the appearance of a dog)

Please explain your breed preferences.

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Select Color*

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Do You Have A Preferred Dog?*

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List Other Dogs You Are Interested In

Please select all that apply to the following statement. It is CRITICAL that my foster dog...*

Select All That Apply

When Will You Be Ready To Foster?*

Tell us any other information you think we should know about you or your experience, or list any limitations or concerns you may have about fostering an animal.

I am interested in receiving pet related services and products

Yes

Authorization

Authorization:*

All dogs placed through the Eleventh Hour Rescue will have health checks, personality and temperament evaluations, and will be spayed or neutered prior to placement unless a medical condition exists, diagnosed by a veterinarian, that would prevent this surgery. I understand that this is a preliminary application and that there may be no dog available in rescue at this time that will fit my situation & preferences. I understand that if a dog should become available, that I will be required to provide further information including, but not limited to, documentation of homeowners or renters insurance. I further understand that all information on my Preliminary Rescue Foster Application will be kept confidential; and that my application will be kept on file until I notify the Eleventh Hour Rescue that I am no longer interested in a rescue I understand that the Rescue reserves the right to deny any foster application in our sole and absolute discretion. The reason for any such denial determination shall remain confidential. I understand and agree *

I agree

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