First Name:
Last Name:
Address:
Apt. #:
Date:
City:
State:
Zip Code:
Email:
Home Phone:
Cell Phone:
Work Phone:
Occupation:
1. Do you live in a:
House
Apartment
Condo
[For safety reasons, HSR does not place our Shelties in mobile/trailer home environments]
Do you:
Rent
Own
If you rent, do you have the landlord's permission to keep a dog?
Yes
No
[Please attach the form above.]
Do you have a yard?
Yes
No
Is it fenced?
Yes
No
[Single dwelling homes must have a fence to protect sometimes nervous rescued Shelties that might tend to bolt.]
What type of fencing?
Chain
Wood
Other
Please describe:
2. Is someone home during the day?
Yes
No
Please explain:
3. What provisions will be made for your Sheltie if no one is home during the day?
Loose inside?
In crate?
In fenced yard?
[Our resuced Shelties must be kept in doors.]
4. Where will the dog sleep? Please explain:
5. Please explain your responses below. During the last two years:
6. Do you have children at home?
Yes
No
If yes, number:
Age(s):
[HSR trusts that your children are experienced with and kind to animals. Please note: Because we cannot know all the personalities and behaviors of the children, HSR will not place our dogs in homes that have a baby sitting/day care home business.]
7. Do you have other pets at home?
Yes
No
If yes, number:
Age(s):
Are all pets spayed/neutered?
Yes
No
[Due to the many health benefits accruing from spaying and neutering, as well as to prevent accidental litters, we require that all resident pets must be neutered/spayed. However, we do welcome knowledgeable, professional breeders who are members of the ASSA and their local breed clubs and who would like to work with our program to help our Shelites.]
If Yes, are the pets vaccinated and on heartworm preventative?
Yes
No
If Yes, do your pets get along with other dogs?
Yes
No
8. HSR will provide all medical care, heartworm and parasite preventative. Are you preparied to assume the responsibilities of feeding, bathing, grooming, and caring for your rescue Sheltie, including emotional rehabilitation for a traumatized dog and crating for a dog going through heartworm treatment?
Yes
No
9. Will you follow all veterinarian instructions provided and administer all prescription medications and H/W preventative to your foster?
Yes
No
10. Are you prepared to keep your foster crated if going through H/W treatment?
Yes
No
11. Are you prepared to assume the responsibilities of contacting HSR officials for any medical emergencies? (For example, if a dog is going through Heartworm treatment and begins throwing up and becomes listless, this may be an emergency.)
Yes
No
12. Do you agree that HSR Coordinators make all medical and adoption decisions for our program dogs?
Yes
No
13. Will you let HSR officials know if you are planning to take your foster out of town or state for family visits or recreation?
Yes
No
14. Though HSR does not accept vicious dogs into our program, we do not know the histories of many of our rescues. Are you prepared to contact HSR immediately if your foster dog bites anyone or injures another pet?
Yes
No
15. Will you keep the dog confined in a fenced yard when let outdoors, walk/exercise the dog regularly, and allow the dog indoors?
Yes
No
16. Do you understand that Shelties are known for being 'barkers'?
Yes
No
17. Do you understand that Shelties can be shy and aloof with new people?
Yes
No
18. Do you understand that only HSR officials may place your foster Sheltie in an adoptive home?
Yes
No
19. Foster parents are encouraged to maintain an 'aunt' or 'uncle' relationship with the dog in their care; but it does occasionally happen that the foster parent and dog bond so completely that adoption into this home is best for the dog and family, which we would be happy to work with. Do you understand that if you wish to adopt your foster Sheltie, you must complete the adoption papers and pay the fee(s) listed on the adoption description and application pages?
Yes
No
20. Are you willing to allow a Houston Sheltie Rescue, Inc. Rescue Program representative to visit your home by appointment?
Yes
No
21. Name and phone number of your Vet:
Name:
Phone:
I hereby authorize the veterinarian named herein to release information about me or my pet(s) to Houston Sheltie Rescue, Inc. as necessary to evaluate this application.
22. How did you hear about Houston Sheltie Rescue, Inc. Rescue Program?
Internet Search
Petfinder
Vet, Clinic, Pet Store, or Shelter Referral
Name:
Breeder
Name:
Dog/Obedience Club
Name:
Another Rescue Group
Name:
Friend/Neighbor
Name:
Other
Please explain:
I am in full agreement with the Houston Sheltie Rescue, Inc. Rescue Program Foster Care Responsibilities . By signing below I am attesting to the truthfulness of my answers.
Electronic signature:
Electronic date:
* Code: