Name *

First Name

Last Name

Are you 21 years or older? *

Yes

No

I *

Rent

Own

I have owned a pet(s) in the past five years: *

Yes

No

Spayed/Neutered:

Yes

No

Current on Vaccines? Distemper - Parvo - Rabies

Yes

No

Tested for Hearworm annually and on Seasonal Prevention?

Yes

No

Spayed/Neutered?

Yes

No

Current on Vaccines? Distemper - Parvo - Rabies

Yes

No

Tested for Heartworm annually and on Seasonal Prevention?

Yes

No

Spayed/Neutered?

Yes

No

Current on Vaccines? Distemper - Parvo - Rabies

Yes

No

Tested for Heartworm annually and on Seasonal Prevention

Yes

No

I have a veterinarian: *

Yes

No

I have: *

A fenced in yard

A stationary tie-out

An outdoor run

Invisible Fencing

A dog house

If a fenced in yard, what type? *

Six-foot privacy

Five-foot chain link

Three-foot picket fence

Other

When I am NOT at home, or not able to supervise my foster dog, my pet will be: *

In the yard

In the garage

Loose in the house

In a designated room in the house

Crated in the house

I understand and accept that a representative from Pound Buddies Animal Shelter and Adoption Center may do a home visit prior to my first foster animal and a home visit as follow up after my foster animal's arrival. *

I accept

I decline

My foster dog needs to get along with other dogs: *

Yes

No

Or cats/other animals *

Yes

No

A member of my household is allergic to dog hair/animal dander: *

Yes

No

I acknowledge the foster responsibilities: *

Accept

Decline

By typing in my FULL NAME, I understand that I am submitting the electronic equivalent of a handwritten and binding signature. *

Accept

Decline