Please answer all questions as incomplete applications cannot be processed.
If the question doesn't apply to you, please enter "n/a" as the answer.
Use "tab" key to move between fields. "Enter" key will clear the form.

Please check all that apply in your household:

Name

Address

City

State

Zip Code

Phone One

Type

Phone Two

Type

Phone Three

Type

E-mail

How often do you check email?

Preferred method of contact

Number of human adult males in household:

Number of human adult females in household:

Number of human teens in household:

Number of human children 12 years old or less in household:

Number of canine females in household:

Are all females spayed?

Number of canine males in household:

Are all males neutered?

List number and type of other animals in household

Are you available for events and fundraisers?

Are you available for pulls and transports?

Are you available for fostering?

Number of dogs willing to foster at one time:

(Two is the maximum number of fosters that we allow for a Foster Home)

Are you available to foster a special needs dog?

Preference for sex of foster dog(s)

Name of your current or previous vet:

Phone number of your vet:

May your vet be used as a reference?

Are all others in the household aware of your intent to foster a dog?

Is anyone in your house allergic to animals?

Type of residence:

Do you own or rent?

If renting, does the landlord allow pets?

Do you have a swimming pool?

Do you have a fenced yard for the dog to use?

If yes, how large an area is fenced, what kind of fencing, and how high is it?

Does a door from your house open directly into the fenced yard?

During the day?

During the night?

During family absences overnight?

While you are at work?

Where will you keep the dog:

If dog is destructive when left alone?

Do all adults in the house work?

Is someone home during the day?

Maximum hours your dog will be left alone during a 24-hour period?

Busy household - visits by friends, in and out a lot, children, parties at home

Noisy - TV, stereo, machinery, tools, children playing, dogs barking

Moderate - normal comings and goings

Quiet - "homebodies", few guests, come home and stay home

Lots of children in the neighborhood

Live on a busy street

If your application to become a foster home is approved, a home inspection is required by the Department of Agriculture.

If you wish to volunteer by doing
(please include tag#)

Volunteer Application Form