Please submit the following application if you would like to be considered as a foster for K9 Orphans. We rely on our foster families so much, and value each and every one of them! First Name * Last Name * Spouse/Partner/Roommate Name Address * City * State * - - Choose One - - AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code * List your main contact number first, followed by others if you wish Type of number * Cell Home Work Phone Number (w/area code) * Type of number Cell Home Work Phone Number (w/area code) Type of number Cell Home Work Phone Number (w/area code) Email * Are you on Facebook? * Yes No How old are you? * Occupation/Place of Work * How many adults 21 and older live in your home? * List name, age, sex, and relationship * How many individuals under 21 live with you? * List name, age, sex, and relationship * Does any member of your household suffer from allergies to animals? * Yes No If so, please explain in detail. How many hours a day will the dog be home alone? * Where will the dog be kept when you are not at home? (crate, pup pen, outside kennel, loose indoor or outside) * Do you have a crate to keep the dog in? * Yes No How will you exercise the dog? (daily leash walks, cable or pup run in yard, free to run in fenced yard, free to roam off leash and unsupervised in unfenced area, dog park, etc) * How will the dog be cared for during overnight absences or while on vacation? * What is your housing situation? (own, rent, live with parents, etc.) * If you rent, have you received the landlord's approval to foster a dog? Yes No If you rent, provide your landlord's name and phone number for verification. If your landord allows dogs, is there a breed restriction? Yes No If yes, please list breeds not allowed Does your home owner's insurance allows you to have they type of dog you would like to foster? * Yes No Not sure N/A (rent) What is the size of your yard? * Small Medium Large Is your yard fenced? * Yes No Partially fenced What type of fence? What is the height of the fence? Do you have other pets? * Yes No If so, provide the following for each pet: name, breed, gender, age, spayed/neutered, shots up-to-date? Are you familiar with heartworm disease and prevention? * Are your dog(s) current on all vaccinations? * Yes No Are your dog(s) vaccinated against kennel cough? (Bordatella vaccination is highly recommended) * Yes No Are your dogs accepting of new dogs in their home? * Yes No Is the foster dog able to have a separate safe haven away from your dogs if needed? * Yes No Do you have any livestock that a foster dog could come in contact with? * Yes No If so, please describe What size dog would you like to foster? * Small Medium Large Extra Large What breeds are you interested in fostering, or are there specific breeds you would NOT consider fostering? * How many years have you been involved with dogs? * What breeds have you had experience with? * What type of experience do you have? (pet, training, showing, breeding, etc.) * Do you have any special skills? (trainer, vet, groomer, etc.) * Have you ever fostered dogs for another rescue group? * Yes No If so, list the name of the group(s), dates fostered, and your overall experience with them. Are you willing to take a dog for obedience classes? * Yes No If no, please explain. Are you willing to house train a dog? * Yes No If no, please explain. Have you ever had a complaint with Animal Control? * Yes No If yes, please explain. Please supply the name and phone number of your current veterinarian, or the one who saw your previous pet(s). If the records are under a different name than yours, please list that here. If you have never had a pet, please provide the name of your employer, clergyman, or anyone not related to you who can attest to your character. Vet references are preferred. * Please call your vet and give permission for them to release information to K9 Orphans, Inc. Failure to do so can result in a delay in the processing of your application. List three additional references who are not related to you and are not affiliated with K9 Orphans, and their phone numbers. * How did you hear about K9 Orphans? * Signature * By typing your name you agree that all information provided on this form is correct to the best of your knowledge. Date * Security Code *