IN ORDER TO BE CONSIDERED AS A FOSTER HOME, YOU MUST:
  • Be 18 years of age or older;
  • Have identification showing your present address;
  • Have the knowledge and consent of your landlord;
  • Be able and willing to spend the time and money necessary to emergency medical treatment, and proper care for a pet.
  • Be agreeable to a home inspection.

Required Fields marked with *)
Please provide the following information about yourself:
*Your Name:
*Street Address
*City, State & Zip
*Work Phone
   (Include Area Code)
*Home Phone
*Email
Please provide the following information:
Is this your first experience with a dane?
Yes No
Do you own any pets at the present time?
Yes No
If so, please list:
Name(s), Breed/Species, Age, Sterilized, Declawed
How many dogs have you owned in the past 7 years?
How many cats have you owned in the past 7 years?
What happened to those pets? List Breed/Species Age, Sterilized?
Who is your veterinarian?
Name:

Street Address
City, State & Zip
Phone
E-mail
How long have you lived at the above address?
How many people live in your household?
Do all the adults know that you plan to foster?
 Yes No
If there are children in the household, what are their ages?
How will the foster animal(s) be housed?
(Be specific - inside only, inside/ outside, outside only, doghouse/ pen)
How long will this pet be left alone per day?
Where do you live:
house
apartment
mobile home
duplex
Do you:
Own
Rent
If you rent, does your lease allow pets?
Yes No N/A
If you rent, please provide your landlord's contact information:
Landlord's Full Name
Street Address
City, State & Zip
Work Phone
Home Phone
FAX
E-mail
Have you or anyone in your household ever been convicted of animal cruelty, neglect, dog fighting, or other animal-related crime?
Yes No
I, the undersigned, agree to provide proper care for any animal in my possession, temporary or permanent. I understand that Dane T.R.A.I.N., Inc. does not carry liability insurance for my home or vehicle, and I agree to hold the Dane T.R.A.I.N. harmless for any damages caused by myself or others, the animal, to or by my vehicle and to my home while I am caring for an animal for Dane T.R.A.I.N. I also agree to carry liability insurance on my automobile and home owner insurance for my property. I understand that I am a volunteer and not an employee of Dane T.R.A.I.N., Inc. By submitting this form, Dane T.R.A.I.N. has my consent to verify my landlord consent (if applicable) and contact my veterinarian. I realize that this/these dogs have not been totally evaluated as to temperament and relieve Dane T.R.A.I.N. of liability.

By checking this box, you agree to the above. (MUST BE CHECKED)




Created by Laura Beck.
Copyright © 2003, 2004, 2005 Dane Train Network, Inc. All rights reserved.
Revised: January 15, 2005