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*