ONE DOG AT A TIME RESCUE
FOSTER APPLICATION
P.O. Box 76, Warsaw, IN 46581-0076
odtr01@gmail.com
FOSTER APPLICATION
P.O. Box 76, Warsaw, IN 46581-0076
odtr01@gmail.com
(Applicants must be 21 years of age or older)
Please circle Yes or No, whichever is applicable.
NAME: _________________________________________ Date: ___________
There are no wrong answers, we just need the information to determine which dog would fit for which person/family. All applications will be kept on file for one (1) year or unless you notify us that you no longer are able to foster.
A home visit will be performed before any animal will be placed.
1. Have you ever given up/relinquished an animal before? Yes No
If the answer is yes, please explain:
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2. Do you have experience with sick or injured animals? If so describe: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
3. Do you have experience with older animals? Yes No
If the answer is yes, please describe:
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________
4. Do you have experience with newborn/nursing moms and young animals? Yes No
If the answer is yes, please describe: _______________________________________________________________________________________________________________________________________________________________________________________________________________
5. We periodically have dogs who are not really wild, but who need socializing.
Are you willing to work with this type of dogs? Yes No
If the answer is yes, briefly describe your approach to socializing these dogs or puppies.
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6. Are you willing to foster special needs dogs? Yes No
Please circle the category/categories you would consider fostering:
Bottle Babies Needs Socializing Pregnant Heartworm Positive
Needs medication Wound care Special Food needs Other _____________
7. Do you understand the need to initially isolate the foster animals from your other animals? Yes No
8. Are you able and/or willing to bring the foster animal to adoption fairs? Yes No
Are you willing to bring the animal to an adoptive parent’s residence? Yes No
9. Are you able and/or willing to take the animal to one of our veterinary clinics if necessary? Yes No
10. What type of home do you live in? House Apartment Condo/Townhouse
Mobile Home Other (please explain)_______________________________
11. If you rent, does your landlord allow you to have animals? __________________________
Please list landlord’s name and phone number. ____________________________________________________________________
12. If you rent, you must get a written statement from your landlord saying that you are allowed to have animals. Will this be a problem for you? _____________________________________________________________________
Please note: Home ownership will be verified and if you rent, a check with the landlord will be verified.
13. Are there any children that visit your home frequently? Yes No
If the answer is yes, what are the ages of these children? _____________________________________________________________________
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14. Do you have a fenced yard for a dog? Yes No
If yes, Type and Height of Fence _________________________________________________
If no, how would you contain the animal when it needed to go outside? _____________________________________________________________________
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15. Would you need a crate for crate training of a dog? Yes No
16. Are there any regular visitors (human or animal)to your home? Yes No
If the answer is yes, please explain. ________________________________________ _____________________________________________________________________
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17. Does everyone living in your household agree to foster a pet at this time? Yes No
18. Please list all the members of your household. Include name, age, and relationship.
ALSO, please specify if anyone in your household has ever HARMED an animal.
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19. Is anyone in your household allergic to dogs? Yes No Don’t Know
20. Are you willing to keep the animal/animals until a good forever home is found? Yes No
(See question #41 for further explanation.)
21. If the foster doesn’t work out, are you willing to foster the animal until another suitable home is found? Yes No
22. Who will be the primary caregiver for your foster(s)? __________________________________________________________________________________________________________________________________________
23. Where will the animal be kept when you are not home?
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24. What arrangements will be made for the animal when you are out of town?
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25. Are you aware of the major infectious diseases of dogs? Yes No
26. Have you ever known of an animal to get parvo at your current residence? Yes No
If the answer is yes, when?___________________________________________________
27. Are your animals current on their vaccinations? Yes No N/A
If the answer is no, please explain:
_______________________________________________________________________________________________________________________________________________________________________________________________________________
28. Have you ever fostered for another rescue group? Yes No
If the answer is yes, please describe your experience: _____________________________________________________________________
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29. Do you have the space and ability to isolate the foster animal from other animals, if necessary? Yes No
30. Are you willing to work with an animal who has behavior problems? Yes No
31. Are there other animals current in the home? If yes, please list type, age, temperament, altered or unaltered? Do they get along with dogs? _____________________________________________________________________
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32. How will you handle a dog that chews inappropriate items?
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33. How will you handle an animal with inappropriate elimination problems?
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34. How will you handle a dog that scratches or bites you, a child, or another person? _____________________________________________________________________
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35. Will you let young children interact with the animal without adult supervision? Yes No
36. What precautions would you take to properly introduce a new dog to your home if you have others animals (other cats, dogs, birds, rabbits, etc.)?
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37. Please list the name and phone number of each vet where your animal(s) have received care over the last 5 years: (Include the owner name(s) under which the records can be found.)
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PLEASE NOTE: We will verify this information with your current vet. Your signature on this application gives us the authority to do so.
PLEASE NOTE: If you do not have any animals and do not have a current vet, we will require three (3) references. Name, phone number, relationship to you.
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38. Have you ever had an application rejected for adoption of an animal from a rescue/animal control facility/shelter? Yes No
If the answer is yes, please describe: ____________________________________________________________________
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39. Does your homeowners/rental insurance have any restrictions for any specific breeds?
Yes No If yes, please specify ____________________________________________________________________
40. What is the maximum amount of time you could foster an animal? (Some of the animals will be short term (1-2 weeks) and some may be longer. Those animals that are being fostered for situations such as military service, may be a much longer commitment time. The less we have to move an animal the better so please be honest in this answer. Again, there is no right answer or wrong one. We just want the best placement possible for the animal and the foster parent.) _______________________________________________________________________________________________________________________________________________________________________________________________________________
41. If the foster animal would suffer an injury (whether accidential or not) while in your care, ODTR would require that you are responsible for half of the veterinary care bills to treat the dog. Do you have a problem with this? Yes No
If yes, please explain ___________________________________________________
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42. Would you require assistance with buying any medicine (basic concerns such as ear mites, flea medicine, de-worming, etc.) for the foster animal, if necessary? Yes No
43. One Dog at A Time Rescue will require that you send weekly updates on the animal’s health, problems, likes, dislikes, or anything else you would like to report. This report will be given to the adoptive family. Would this be a problem for you? Yes No
44. Do you have a limit on the size of dog you want to foster? (circle all that apply) Puppy Small (1-30 pounds), Medium (31-70 pounds) Large (over 70-120 pounds) X-Large (over 120 pounds) No preference
45. Do you have any other restrictions on the type of dog you WILL NOT foster? (ex. Breed, altered/unaltered, indoor/outdoor, needs medicine, needs training, etc.) _______________________________________________________________________________________________________________________________________________________________________________________________________________
46. Do you have a preference on the Breed of dog you will foster? __________________________________________________________________________________________________________________________________________
47. Is there anything you feel that we should know about your fostering an animal? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
48. Do you have any concerns that you would like to address? YES OR NO
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PLEASE READ THE FOLLOWING CAREFULLY: (initial after each paragraph)
We would not knowingly place an animal with a serious health condition. BUT it may not be known if a stray or previously owned animal has been exposed to an illness or has a hidden genetic disorder. Under these circumstances, we cannot guarantee the health of this pet. ____________
The information I have given in this application is correct to the best of my knowledge. I understand that One Dog at a Time Rescue (also known as ODTR) reserves the right to approve or reject this application. Applications are often approved pending current pet vaccinations and landlord approval. In fairness to the animals, the selected pet may be given to another foster parent if it can not be “held” to allow for time to take care of these items. An individual animal will not be taken out of “foster home needed status” and held for an extended period of time. __________
I understand, as previously explained, that you will be contacting my veterinarian for vaccination and health history of the pets that I currently own or have owned in the past. I release my veterinarian to provide that information to you. I am aware that if prior to placement of a pet from ODTR, my currently owned pets must be current on needed vaccines. To protect my animals at home, if they are not current, same species adoptions will require a waiting period for my own pets to gain immunities provided by the vaccines. If a suitable adoptive home is found for the animal you are fostering, you will be given first opportunity to adopt the animal. You will have 24 hours from notification that an adoptive home has been found for the animal to notify ODTR that you wish to adopt the animal yourself. If you do not wish to adopt the animal, you will be required to retain the animal until the adoption process is completed. HOWEVER, this adoption preference DOES NOT extend to friends or family members. They must fill out an application form, be placed in the adoption queue for that animal, and follow all ODTR adoption procedures. ______________
FOSTER HOME AGREEMENT
Please read, understand, and initial.
Foster home should be experienced in the basic care and handling of the type of animal to be fostered ______________
Foster home should be qualified and have adequate resources and experience to provide for the medical and care requirements of the animal ____________
Foster home should have the space to separate/confine foster animals from other animals in the home _________________
Foster home will contact One Dog At A Time designate for permission before taking a foster animal to a veterinarian, if possible. IF AN EMERGENCY, medical treatment should be sought IMMEDIATELY and ODTR contacted as soon as possible. ____________
Foster homes will keep detailed records of any medical treatments and care given to the foster animal. ____________
All foster home current resident pet(s) must have up-to-date vaccinations ________
If the foster home resident pet(s) contracts a disease or is injured by a foster animal, One Dog At A Time Rescue will not be liable for any expenses associated with the foster home resident pet(s) ________
If the foster animal becomes lost or runs away, the foster home must immediately contact One Dog At A Time Rescue, the local police department and animal control agency. ___________
One Dog At A Time Rescue has the right to inspect the foster home or to request the return of any foster animal(s) at any time ___________
Foster animals will be assigned to foster homes at the discretion of the One Dog At A Time Rescue Coordinator _________
The Foster home will sign the One Dog At A Time Volunteer Application/Agreement and Rescue Foster Agreement before taking any foster animal to their home________
This application and all paperwork regarding fostering One Dog At A Time Rescue animals is the sole property of One Dog At A Time Rescue _________
If any misrepresentations have been made, One Dog at a Time Rescue reserves the right to demand the immediate return of any foster animal back to One Dog At a Time Rescue. ___________
ONE DOG AT A TIME RESCUE
FOSTER APPLICATION
P.O. Box 76, Warsaw, IN 46581-0076
odtr01@gmail.com
I certify that the above information is true and complete to the best of my ability. I further authorize that One Dog at A Time Rescue may contact any and all of the listed references and I authorize the release of information from any of the aforementioned references to One Dog at A Time Rescue.
I have read and understand the Foster Policies of One Dog at a Time Rescue and agree to them. I further agree to hold harmless One Dog at a Time Rescue , AND/OR any representative of One Dog at a Time Rescue, for any injury sustained to myself, family members, pets and/or friends as a result of having fostered this animal.
______________________________________ ____________________
Signature of Applicant Date
Rev. 1- 11/10/10
Copy and print out. Fill out application. Give to ODTR member or e-mail me and I'll give you a place you can send it.
