Foster Application

First name

Last name

Email

Phone

Birthday

Month

Day

Year

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Do you

Rent

Own

Live with parents

Other

If Renting: Please indicate landlord contact information

Household setting

Urban

Royal

Suburban

Describe your Homes Activity Level

Busy/Noisy

Moderate comings/goings

Quiet with occasional guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)

Does Anyone in your Household have Allergies to Animals?

Yes

No

Are all members of your Family agreeable to Fostering a Dog?

Yes

No

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sexe, UTD Vaccines, Heartworm, Living/Deceased)

Do you have preference off the sex of the dog willing to foster?

Yes

No

Are you willing to foster a dog of any age?

Yes

No

If not, what age would you consider?

Small

Medium

Large

Please describe the type of dog you are willing to foster (Please include breed, coat length, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes.

Are you willing to take your foster dog to vet appointments at a convenient time for you?

Yes

No

Do you drive or have access to a vehicle to bring your foster to events and appointments

Yes

No

If No please explain

Are you willing and able to medicate your foster, even if it just a monthly heartworm preventative?

Yes

No

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?

Yes

No

Have you had any experience with with an emotionally or physically neglected or abused dog?

Option 1

Option 2

If Yes please explain

Are you willing to use a crate for a dog if recommended?

Yes

No

Do you have a fenced yard?

Yes

No

Partial

How many hours in a day would the foster be left alone?

What are you plans to exercise your foster? Please list any parks near by or trails, how many walks a day, approximate length, and activities such as agility.

Please list 3 personal references with names, addresses, phone numbers and how related. We prefer it not to be all relatives.

Vet Reference: Full Name, Address, Phone Number

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Koch's Corsos & Rescues animal fostered by me.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Koch's Corsos & Rescues and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog.

I accept full responsibility for the dog(s) actions at all times, and release Koch's Corsos & Rescues from any liabilities or damages that may be incurred because of fostering such dog(s).

I agree to have Koch's Corsos & Rescues complete reference call checks and conduct a home visit inspection to be able to approve my foster application.

I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to Koch's Corsos & Rescues and try to give Koch's Corsos & Rescues a 2 week period to try and find another suitable foster for the dog(s).

Signature

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