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First Name *

Last Name *

Street Address *

Zip Code *

Email Address *

Cell Phone *

Do you have a preference for the type of dog you are interested in fostering? *
ie. Puppy, puppies, adult dog, breed, size (large, medium, small)

Do you currently have pets? *

Please list the pets living with you. *

Are your pets vaccinated?*

Do your dogs get along with other dogs?*

Are you willing to foster a dog with medical needs?*

Are there children in your home? *

If Yes, are any of the children under the age of ten years?

Do you have a fenced yard? *

Fence Height *

Where will you keep the dog during the day? *

Where will you keep the dog at night? *

Where will you keep the dog while you are away? *

Would you be willing to take the foster dog to our veterinarian if needed? *

Please provide the name and phone number of a reference who is not related to you. *

I understand that a Houston k-911 rescue representative may visit my home for a home inspection before my foster application is approved. *

I agree that all statements contained in this document are made by me, and are truthful. *

Do you agree to absolve Houston k-911 rescue and all of it's representatives from any liability in reference to a dog under the custody of Houston k-911 rescue? *

Name *

Street Address *

City, State *

Zip Code *

Phone

Email *

Name of pet that you are interested in

Where are you employed*

Occupation *

Work Phone *

Spouse's Name *

Spouse's Occupation *

Our adoption process includes a home visit. Are you willing to let a representative visit your home by appointment? *

If you answered no to the previous question, please explain.

Personal non-family reference #1 (Name, Phone, Relation) *

Personal non-family reference #2 (Name, Phone, Relation) *

What is your reason for wanting to adopt a pet at this time? *

Description of residence *

Do you... *

If you are renting, what is the name of the property, property owner, and phone number? *

Does your Homeowners Association have any restrictions on pet ownership?

If you answered "YES" Above, Please Explain.

Do you have a fenced yard? *

Fence Height *

Number of adults in the house *

Number of children in the house *

Who will care for this dog? *

Where will you keep the dog during the day? *

Where will you keep the dog at night? *

Where will you keep the dog while you are away? *

On average, how many hours will the pet spend alone? (please specify daily or weekly) *

On average, how many hours will the pet spend outside by itself? (Please specify daily or weekly)

How will you handle this pet's exercise and potty breaks? *

Please list all animals currently living at your address and any pets you have owned in the last three years: (please include age, species, breed, and sex) *

Spayed/Neutered *

If you answered "no" to the above question, please explain.

Vaccinated *

If you answered "no" to the above question, please explain.

What happened to the pets that are no longer with you? *

If adopting a dog, will you obedience train the dog? *

Please describe the extent of care that you are willing to provide should your pet have special medical needs now or later in life. *

Will you have your pet vaccinated annually by a veterinarian?

Please describe what you know about the causes and prevention of heartworms. *

How will your pet be cared for when you are out of town? *

If you currently have a veterinarian, please provide the name, address and phone number. *

Have you owned this breed/mix before?

Have you owned a rescued animal before?

Have you ever adopted from a rescue group or shelter? *

If "yes", please provide the name of the rescue or shelter.

Have you applied to adopt an animal and been declined? *

If "yes" please explain.

Have you ever given up an animal? *

If "yes", what did you do with the animal(s) and why? *

What qualities are you looking for in a pet? *

What traits or characteristics are you sure you do NOT want? *

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