First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
County
Email*
Home Phone
Work Phone x
Cell Phone*
Co-Applicant Name (if available)
Co-Applicant Phone Number (if applicable)
Co-Applicant Age (if applicable)
Do you own or rent your home* Choose one: Lease Own Rent
If you rent, please enter your landlord's name and phone number
How long have you lived at your current residence?*
Does your landlord, homeowner's association, county/township/municipality have any restrictions?*
List two references and phone numbers (who are not family members and do not live with you *NOTE* application can not be processed without phone numbers)*
How many people reside in your household*
Please list the names and ages of all adults in your home*
Out of the number of residents in your household, how many are children?
If you have children, have they been around animals and pets before? Choose one: Yes No
Does anyone in your house currently have allergies to pets or have asthma?* Choose one: Yes No
Who in the household will care for the pet*
Is your yard fenced* Choose one: No Yard Unfenced Yard Kennel or Dog Run in Yard Yard Partially Fenced Yard Completely Fenced
What type of fence Choose one: Privacy Chain Link Invisible
List any pets you currently own, or have owned, in the past ten years, as well as their ages.*
Are/Were all of these pets spayed/neutered?* Choose one: Yes No
Are/Were all of your pets up to date on vaccinations?* Choose one: Yes No
Where are these animals now?*
Veterinarian's Name and Phone Number. If this is your first pet, please provide who you will use going forward.*
Why type of dog are you willing to foster?*
What traits are you looking for in a pet
How much time will the animal spend alone during the day*
In the event your pet has an accident in your home, what type of corrective action do you plan to use?*
Are you aware of crate training?* Choose one: Yes No
Do you agree to only use positive reinforcement methods of training as opposed to physical methods (i.e., hitting, punching, kicking)?* Choose one: Yes No
I certify that the information entered on this applicant is true. Enter your name and date*
How did you hear about us*