Foster Home Application – North West Great Dane Rescue

Name *

First and Last

Street Address *

City *

State *

Zip *

Phone number *

Best number to reach you, perferabley cell

Email Address *

Occupation *

Employer

Best time to call (check all that apply) *

Day

Evening

Weekend

Do you own or rent? *

Own

Rent

If renting, do you have permission to house a Dane?

Yes

No

Please list the names and ages of all living in your home

Any regular visitors who will be in contact with foster dogs? (ie children, grandchildren, employees, other pets) *

Do you have other pets living in your home?

Yes

No

Pet Name

Breed

Age

Sex

Altered

Another pet

Breed

Age

Sex

Altered

Another pet

Breed

Age

Sex

Altered

Another pet

Breed

Age

Sex

Altered

Another pet

Breed

Age

Sex

Altered

Is your dog current on all vaccinations, including Bordatella?

Yes

No

Are they accepting of new dogs in their home?

Yes

No

Do your pet(s) have a safe haven away from foster dogs?

Yes

No

Do you have livestock that your foster dog could be in contact with? *

Yes

No

Experience with other animals *

Please list dog breeds you have had experience with, specify if Great Danes, and the experience level (training, showing, breeding, family pets, etc.) *

If you have fostered before? when/how/with who? *

Preferences or restrictions with foster dogs? (M/F, etc) *

Do you have an area to isolate a dog for health reasons? *

Yes

No

Can you accommodate a NWGDR crate at least 4' long? *

Yes

No

Will you foster a dog with kennel cough? *

Yes

No

Will you foster a dog with injuries? *

Yes

No

Will you foster a mother with a litter? *

Yes

No

Will you foster a puppy under 6 months old? *

Yes

No

Will you foster a dog that is not potty trained? *

Yes

No

Do you have special animal care skills (trainer, groomer, etc.)? *

Fostering a dog may put you over a legal pet limit. Does your city/county have a dog limit and/or a fostering exception for rescue organizations? *

Yes

No

Unknown

Have you, or other persons in your home, ever received a complaint from Animal Control; or been convicted of any felony; of an animal-related misdemeanor? *

Yes

No

If yes, please explain

Length of time you are willing foster a dog? *

Hours per day your dog would be unattended? *

Can you transport a Dane if necessary? *

Yes

No

Do you have a fenced yard? *

Yes

No

Specify height and type

Do you have a crate? *

Yes

No

Specify size and type

Do you have a kennel run? *

Yes

No

Specify size and type

Any other secure confinement you can provide?

During the day, will the dog be house (check all that apply) *

At night, will the dog be housed (check all that apply) *

Loose in the house

Crated in the house

Other

Please list your VETERINARIAN *

Telephone Number *

Please list a non-relative REFERENCE who is knowledgeable about your care of dogs *

Telephone Number *

I certify that the above information is true and correct. I understand that I must keep control of all animals in my home and will be responsible for injuries by/to a foster dog. I give permission for NWGDR to contact above references to obtain information about me and/or my care of/work with animals. Information from this form, and any interviews, will be kept confidential by NWGDR unless disclosure is required by law.

I agree

I disagree

By signing below (including electronic signature), I agree to hold NWGDR harmless for Injuries or damages caused by NWGDR foster dogs.

Print name here

Date of signing

Date

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