Canine Foster Application

FOSTER CAREGIVER CANINE APPLICATION

The information provided in completing this profile will enable OPHS to find the most satisfying foster animal and experiences for you.  Please be sure to complete all sections of the profile thoroughly and as honestly as possible.

1.Name:__________________________Phone#: Home____________Cell _________

Physical Address:__________________________________________________________________                                    Street            City   State  Zip

Do you live in a: 0 House  0Apartment  0 Mobile Home  0 Condo  0 Duplex 0 With Parent/Relative    Other______________________

2. Do you: 0 OWN  0 RENT      

3. Landlord

Name:_______________________________Phone:_____________________________

4. How many adults are in your home? _____________________ Children? _____________________

5. Ages of children: __________________________________________________________________

6. Are all household members familiar with dogs?  ___________Yes  ___________No 7. Does anyone in your home have allergies to dogs?  _____________Yes

No 8. Please list the following information about pets currently living in your home: Type of Animal? Altered Y/N? Date last Vaccinated? Age ?  1._______________________________________________________________________________  2._______________________________________________________________________________  3._______________________________________________________________________________  4._______________________________________________________________________________   5._______________________________________________________________________________

9.   What previous foster animal experience do you have? _____________________________________________________________________________  ________________________________________________________________________________  ________________________________________________________________________________

10.  Have you had any pets die or become lost in the past year?  __________Yes  __________No   If yes,  please explain: _______________________________________

11.  How many hours per day will the foster dog/puppy be left alone?  _________

12.  Who will be the primary caretaker for the foster dog/puppy? ___________

13.  Is there anyone who will assist you in caring for the foster dog/puppy? __________

14.  How would your pet(s) interact with a foster dog/puppy? _______________ ______________________________________________________________________________ 15.  Where will the foster dog/puppy be kept during the day? ________________ Night? _________

16.  Do you have a fenced yard? ____Yes  ____No  If yes, how high is the fence? __________________ What type of fence? ________________________________________________________________ If no, how will you confine the foster dog/puppy to your property?_______________________________ If no, how will you exercise the foster dog/puppy?____________________________________________

17.  Do you have an indoor area to confine the foster dog/puppy (spare room, crate, laundry room, etc.)?      _______Yes   _______No

18.  How would you feel about a decision that an dog/puppy you are fostering or had fostered, needs to be euthanized due to untreatable health or temperament problems?________________________________________________________________________  19.  Have you considered the negative aspects of fostering, such as:   Cleaning up after puppies?  _______Yes  _______No   Destructive behavior such as chewing, mouthing, and/or scratching? ________Yes  ________No  Excessive barking _______Yes  _______No  Timid and fearful animals that may bite  _______Yes  _______No   Sleepless nights or interrupted sleep?  _______Yes  _______No

20. Do you understand that housetraining a dog/puppy may take several days or weeks?    ______Yes ______No

21.  Are you able to care for an injured or sick dog/puppy on a temporary basis? _____Yes  ______No

22.  Are you able to administer medicine to a dog/puppy if necessary? ________Yes  ________No

23.  Are you willing to care for a dog/puppy that has been recently spayed or neutered?   ______Yes ______No

24.  Are you able to transport the foster dog/puppy to a designated veterinary clinic for care?    ___Yes  ___No        To the shelter or other designated area for adoption? ____Yes ____No

25.  Please check the type(s) of dog(s) you wish to foster:  ____puppy ____adult ____senior ____mother & litter     ____weaned litter  ____orphaned litter       Sex:   ____male ____female  Size:  ____under 15 lbs ____15 – 35 lbs ____35 – 55 lbs  ____55 – 75 lbs ____over 75 lbs

26.  How long are you willing to foster a dog(s)?  ____1 – 7 days  ____1 – 4 weeks  ____as long as it takes to find a permanent home

27.  Do you understand that fostering is a temporary situation until a dog/puppy has found its permanent home? _______Yes _______No

28.  I authorize OPHS to contact the following references: Veterinarian:_________________________________________ Phone_______________________

Personal reference (non-related): ________________________ Phone_______________________

I am aware that animal(s) that I am fostering are still property of the Olympic Peninsula Humane Society and any and all potential adoptions of said animal have to be approved through the Humane Society and proper paperwork must be filled out by shelter staff. I will not and cannot place an animal in my care into a home that is not approved by staff at the Humane Society.  _____Initial

I confirm that all information supplied on this profile is true and correct.  I understand that a brief home visit maybe required before participation in the foster program can be approved.  I also understand that training and support can be provided to me upon request. I understand that all veterinary care must be pre-approved by the OPHS Shelter Manager or Executive Director.   ___________________________________ Signature  _____________  Date

Please deliver your application to 2105 W Hwy 101, Port Angeles or send your application to: PO Box 3124 Port Angeles, WA  98382.

Thank you for your interest in joining our Foster Care Program!