Name
*
First Name
Last Name
Significant Other's Name (If applicable)
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
*
Phone
*
(###)
###
####
Your Date of Birth
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MM
DD
YYYY
Your Occupation
*
Significant Other's Occupation (If applicable)
What is your living situation?
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- select an option -
House
Apartment
Condo/Townhome
Other
If not listed, please explain your living situation.
Do you own your home or rent?
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- select an option -
Homeowner
Renter
If you rent, please provide your landlord’s contact information.
Do you have prior fostering experience or have specific animal training? Neither is necessary, but if so, please provide the name of the organization.
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Please list names and ages of all in the household.
Have any children living in your home lived with or been around dogs? Are you able to supervise or keep separate? Please describe their level of experience around animals.
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Do you have any children, not listed in the household, visit your home and interact with your pets? Are you able to supervise or keep separate? Please describe what their level of interaction will be.
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Please list all current pets, by name, in the household. Include: Name, age, species, gender and temperament.
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Are all current pets up-to-date on rabies and other vaccinations?
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- select an option -
Yes
No
No current pets
Please list your veterinarian, their address, and their phone number? (*Note we cannot process your application without this information. Please call the clinic and give them permission to speak with us.)
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Please list your past pets by name and why you no longer have them. If they saw a different veterinarian than listed above, please include that veterinarian(s) and their phone number.
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Do you do an annual heartworm test on your current pets?
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- select an option -
Yes
No
No current pets
Do you use heartworm preventatives on your current pets?
*
- select an option -
Yes
No
No current pets
What is the name of the heartworm product being used?
Do you use flea/tick preventatives on your current pets?
*
- select an option -
Yes
No
No current pets
What is the name of the flea/tick product being used?
Are all your current pets spayed/neutered? If not, please explain why.
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What is the average number of hours a day the foster animal will spend alone?
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Where will the foster animal be when you are not home?
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Where will the foster animal sleep at night?
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Do you have a fully enclosed fence?
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- select an option -
Yes
No
If yes, please describe height and style?
How do you plan to exercise your foster animal?
*
What gender of dog you would like to foster?
*
What age of dog would you like to foster?
*
What size of dog would you like to foster?
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What issues are you not prepared for with a foster dog?
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What gender of cat would you like to foster?
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What age of cat would you like to foster?
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What issues are you not prepared for with a foster cat?
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Please describe the method or type of training you will use on the foster animal.
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Please describe your normal household energy level so we can best match a foster animal with you or your family. (ex. energetic/active, happy medium, calm/quiet)
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What activities or hobbies do you or your family enjoy?
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Are you able to attend events with the foster animal?
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- select an option -
Yes
No
Is there anything else you would like to share with us about why you'd like to foster for Haven Animal Rescue Nebraska?
Are all members of the household in agreement to foster?
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- select an option -
Yes
No
Please list two references. Include: Name, relationship to you, their address, and their phone number. (*Only one of them may be a family member.)
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I/We understand that by submitting this form I/we are certifying all questions have been truthfully answered and that this submission does not guarantee placement of a foster animal through Haven Animal Rescue Nebraska. Once the initial veterinarian reference check is complete we also agree to a home check either in person or virtual. In addition, I/we agree that any foster animal placed in my/our home will be an inside pet and cared for according to Haven Animal Rescue Nebraska guidelines. By submitting this application, I/we agree to hold harmless Haven Animal Rescue Nebraska when fostering or transporting an animal in my care. I/We agree to voluntarily assume full responsibility for any risks of loss, property damage or personal injury, including death, that may be sustained by me or anyone as a result of fostering while said animal is in my house, and/or any loss or damage of property. I/We also acknowledge that Haven Animal Rescue Nebraska is the current owner of all animals that I/we will be fostering and/or transporting, no matter the length of time or temperament of said animal.
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