Foster ApplicationStep 1 of 812%This application was designed to help us get to know you and to determine which dogs will be good fosters for you. If some of the questions seem personal, that's because they are. The well being of our foster dogs is very important to us and we need to get to know you before entrusting one to your care. Please answer all questions as thoroughly as possible and feel free to ask us questions as well.Contact InformationNameDate of BirthEmail Phone(s)WorkCellAddressCityStateZIPSecond ApplicantLast NameDate of BirthEmail Phone(s)WorkCellAddressCityStateZIPReferencesReference 1NameCredentialsPhone(s)EmailReference 2NameCredentialsPhone(s)EmailFirst NameProfessional InformationWhat is your occupation?How far from home do you work?How many hours per week do you work?Other adult in household’s occupation?How far from home do they work?How many hours per week do they work?About Your HomeHow long have you lived there?The neighborhood is?Do you own the property or are you renting?Own or Rent Own RentDoes your landlord allow dogs?Yes or No Yes NoCan you get it in writing upon request?Yes or No Yes NoDo you have plans to move?Yes or No Yes NoWhen and where?Do you have a fenced yard?Yes or No Yes NoFence material and heightAre you planning to fence?Yes or No Yes No NAWill you allow a home visit by rescue personnel upon request?Yes or No Yes NoOther People In The HouseDo you have other adults living with you?Yes or No Yes NoPlease list their ages and relationshipWho will be the primary caretaker of the dogs?Do you have other children who live with you or visit your home on a regular basis?Yes or No Yes NoPlease list their first names and agesAre the children experienced around dogs?Yes or No Yes NoIs anyone in the home allergic to dogs?Yes or No Yes NoIs anyone in the home afraid of dogs?Yes or No Yes NoDoes everyone in your family want a dog?Yes or No Yes NoAbout Your Experience With AnimalsHave you ever owned a dog before?Yes or No Yes NoHow many?What were their breeds?What happened to them (if you still don’t have them)?If they passed away, please explain how?Do you have any experience with other animals?Do you have any special dog-related skills?Has there ever been a formal complaint filed against you about your pets (to 911, 311, animal control, landlord, etc.)?Yes or No Yes NoTell us about itYour Current PetsDo you currently have any other pets?Yes or No Yes NoWhat kind(s)? (Please, list breed, sex, age, and describe each temperament)Are current pets up to date on all vaccinations and preventative care?Yes or No Yes NoWhy Not?Are they spayed/neutered?Yes or No Yes NoWhy Not?Are all of these pets able to have a separate, safe haven away from a new dog?Yes or No Yes NoDo you anticipate any potential problems with your current pets and your new dog?Yes or No Yes NoHow do you plan to overcome the problems?Your Fostering ExperienceHave you fostered dogs for another rescue group?Yes or No Yes NoIf Yes, which rescue? Please include contact information and dates you volunteeredHow would you describe your overall experience with them?Are you currently fostering an animal with this or any other organization?The Foster Dog’s EnvironmentDo you have a separate area to isolate the foster dog for health reasons if necessary?How many hours per day will the foster dog be unattended?How will the foster dog be housed (indoors loose, crated, with or separate from other dogs, outside?Do you have a crate?Yes or No Yes NoAre you willing to crate train if needed?Yes or No Yes NoYour Requirements For FosteringDo you have a preference forYes or No or No Preference Male Female No PreferenceLength of time willing to foster:Are you willing to foster the following:A dog with kennel cough?Yes or No Yes NoA dog that is injured?Yes or No Yes NoA dog with a litter of puppies?Yes or No Yes NoPuppies being bottlefed?Yes or No Yes NoA dog with behavior problems?Yes or No Yes NoA dog that is aggressive?Yes or No Yes NoA dog that is not housebroken?Yes or No Yes NoAny other restriction(s)?Extra InformationPlease feel free to add any other information you think would be useful for us to know or make any comments that you think could help us place a foster dog with your family.Terms of the Foster Volunteer AgreementI, , hereby acknowledge the following policies and agree to abide by them during the entire time I am fostering dogs for NYC Shiba Rescue, Inc. (NYCSR)I understand that my role is solely as a temporary home, and that although my opinion regarding the match between the foster dog and potential adopters is very important, the ultimate placement of any dogs I foster will be conducted by NYCSR. It is NYCSR's responsibility to review and interview potential adopters. AgreeI will remember in all my dealings with the public as a foster volunteer that I represent NYCSR, and that the public will consider my words and actions to be representative of the attitudes and positions of NYCSR as an organization. I understand that as an individual, I am not authorized to speak for NYCSR, nor can I enter into any agreements for NYCSR; any such activity will be referred to the Board of Directors. AgreeI have read, understand and support the mission of NYCSR. AgreeI understand that I am personally responsible for any and all financial expenses that I incur in my efforts to foster dogs for NYCSR. Although NYCSR may reimburse my expenses, I agree that each expense must be supported by receipts, must be pre-approved by the Foster Program Director, and that any expense over $200 for a single dog must also be preapproved by the Board of Directors. I accept full responsibility for any expenses incurred by me that fall outside of approved expenditures. I will always remember that I represent a nonprofit organization and in no way can profit from any activity related to the organization. AgreeI agree to not leave an NYCSR foster dog in anyone else’s care unless that person is approved to Foster by the Foster Program Director or other NYCSR Board member AgreeI agree to not take any other dogs into my care or home – short or long term – during the time I am actively fostering for NYCSR without written approval from NYCSR. AgreeI understand that NYCSR cannot guarantee or be held responsible for the temperament, behavior, or health of foster dogs that I may handle. I am aware that foster dogs may cause damage to my personal property, other pets, and humans. I will keep dogs securely contained at all times while in my care. AgreeI understand that it is my decision to foster dogs for NYCSR. I will not hold NYCSR liable for any damage, injury or harm caused directly or indirectly through my fostering activities with NYCSR. I carry insurance coverage in the event of personal or liability damages resulting from fostering dogs for NYCSR. AgreeI understand that my foster volunteer position will be terminated if my conduct is deemed in opposition of the mission of NYCSR, or detrimental to the best interests of the dog(s) in my care or of NYCSR. AgreeI understand and agree to all of the above, and support the mission of NYCSR. I understand that this form must be received and approved by NYCSR before I may volunteer for the organization, and that NYCSR reserves the right to refuse my application.Name:Date:
