Foster Application Dog - Southern Tier Animal Control Southern Tier Animal Control

Foster Application - Dog

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Animal Name/ID Number or the type size cat or dog you might be interested in. We will keep your application on file.

Name

First

Last

Current Street Address

Current City Address

Curent State address and zip code

Current township

Date of Birth

Drivers License # and State Issued

Primary Phone

Are you at least 18 yearsof age?

Are you currently employed or retired?

yes employed
yes retired
not employed or retired

If employed name of employer

List all Family members in household (with ages)

Do you or any of your family members have any animal allergies?

If you are applying for a specific animal to foster, what is their name and why do you wnat to foster them?

List all pets in household ie,dog,cat or other include male or female and if the animal is spay/neutered Are they up to date on all vaccines? Answer for each pet..

What type of dog are you willing to foster?

Shy or blind dogs
Easy Everyday dog
Nursing or pregnant mother dog and litter
Older puppies 3 - 6 months of age
Dogs recovering from medical care: injury, surgery, infection, illness
Dogs that require training (ex. loose leash walking, reactivity, etc)
Young puppies less than 1 - 2 months of age
Doesn't matter! Whoever needs it most.

Please describe your experience with medical care or animal training if you're interested in fostering a dog that requires medical care or training?

If you have other pets, are they spayed or neutered?

Yes, all are spayed/neutered
No, my pets are not spayed/neutered
I don't have pets
Some are spayed/neutered some are not
If your pets are not spayed or neutered please let us know why not in the block below

From above please esplain why your pets are not spayed or neutered

Are your current pets up to date on their annual vaccines? A check beside the vaccine is a yes

DHLPP dogs
FVRCP cats
Rabies dogs and cats
check here if any are missing above and explain why in the next block

From above about vaccines please explain why the vaccines have not been given or up to date

What would be the ideal length of time that the foster dog/puppy stays in your home?

Are you able to separate the foster dog from other people aand animals if needed

Yes
No
I'm not sure how

Will you license your dog if you adopt?

Have you ever relinquished a dog if so when and please explain.

Are you aware of dog control laws?

Which best describes where you live

House
Apartment

Is where you live City or Rural

City
Rural

Do you own or rent your home

If you rent give the landlords name and a good contact number.

How many hours, on an average day, will this dog be home alone?

Are you currently fostering? Please tell us about this.

Where will the dog be when you are not at home? Will you crate train the foster

Have you previouslly fostered for any other animal shelter or organization? If so which one? Tell us about your experience

Describe the outdoor space this dog will be using.

What Veterinary hospital that will be used for your new pet?

Please read through and type your initials next to each of the following statement,

Will you keep this dog in your home? Please say yes or no and initial.

I understand that Southern Tier Animal Control Inc. makes no representations whatsoever relating to the health, habits or any other fact about the dog.

I understand that my pet may have an illness that is not immediately apparent and Southern Tier Animal Control Inc, is not responsible for veterinary care should the dog have an illness.

I understand that there is a risk that my current family pet could b exposed to illness and Southern Tier Animal Control Inc. is not responsible for their veterinary care should they become ill.

I understand that it is recommended that my new pet be isolated from my current family pets until it has seen my veterinarian.

If intending to adopt. I agree to call within 5 days of the adoption to make an appointment to take my new pet to my veterinarian (wellness check and schedule spay/neuter appointment)

I understand that a pet needs to be seen by a veterinarian at least once a year for an annual physical, vaccinations and flea/heartworm preventatives.

If adopting I agree to have my pet spayed/neutered within 30 days after the adoption date to receive the $35 dollar deposit back.

When you sign you are signing to notify STAC if you have rehomed/or the dog is no longer in your care. You will furnish the information of where the dog is and information that allows STAC to contact the new owners.

I understand that New York State Law requires written permission before releasing my new animal's medical information to anyone but me. By initialing this form and signing the agreement below, I am allowing Southern Tier Animal Control Inc. to obtain all information concerning my animals from the veterinary hospital that i have provided on this application.

By typing your name below you are signing this document, I am accepting all of the risks associated with the handling of animal during the foster and or the adoption process. I understand that this document will be retained on file by Southern Tier Animal Control Inc. I further attest that the information I have given is true and understand that giving any false or incomplete information may result in the application being denied.

Stop application here the below is for SHELTER INFO ONLY Date Reviewed

Home Verified

Approved or Denied

Foster Application Dog