First Name *

Last Name *

Email *

Phone *

Address *

City *

Postal code *

State *

Date of birth *

If other, please specify:

If renting, please provide landlord’s contact information: *

Do you have a fenced in yard: *

Yes

Are there any slats/openings that could allow a small dog to get in/out? *

Yes

How many adults & children live in your home? *

Name & Age
Name & Age
Name & Age
Name & Age

Is everyone in your home aware that you have applied to foster? *

Yes

N/A

Is everyone agreeable to having a foster at home? *

Yes

N/A

Personal References- only one family member please. *

Name & Phone Number
Name & Phone Number
Name & Phone Number
Name & Phone Number

Please list any veterinarian you may have worked with in the past, for current or previous pets *

Name & Phone Number
Name & Phone Number

Please list all of the pets you have had in the last 7 years, including current pets and those you no longer own: *

Name
Species
Breed
Age
Sex
Altered?
Owned for how long?
What happened to him/her?

Hours perday that foster(s) will be left alone: During the week: *

Less than 4 hours

4-8 hours

8-10 hours

More then 10 hours

We prefer that animals stay with their foster until they are adopted, which means we cannot guarantee how long the animal will be in your care. Do you have any time restrictions when it comes to how long you can foster an animal? *

Do you have any concerns about fostering? If so, please explain: *

I have never been convicted of, or charged with, animal abuse, animal neglect, animal fighting, animal abandonment, or other animal related crime. *

Clear

I agree to allow KMDR to perform a criminal history background check. *

Clear

By submitting this application, I affirm that the facts set forth in it are true and complete to the best of my knowledge. I understand that if I am accepted as a foster, that I am not the rightful owner of the dog and any medical decisions/rehoming decisions will be made by Kane’s Mission – Dog Rescue. I understand that any false statements, omissions, or other misrepresentations made by me on this application may result in an immediate termination of the foster contract and the foster dog to be returned. KMDR shall be held harmless from and against any and all claims and damages of every kind, for injury to any person or persons and for damage to or loss of property, arising out of or attributed to, directly or indirectly, the operations or performance of the above named volunteer (foster) under this agreement, including claims and damages arising in whole or part from the negligence of KMDR. I agree to notify KMDR of any injuries such as illness, escapes, injuries or any concerns pertaining to my foster as soon as possible. *

Clear

Signature & Date *

Clear

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Foster Application

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