Please enable JavaScript in your browser to complete this form.Applicant's Name(s)Street AddressCityZIPStatePhone NumberEmail AddressI would consider fostering a dog with the following characteristics (check all that apply):MaleFemaleSmall (5-20 lbs)Medium (20-50 lbs)Large (50-100 lbs)Special Needs (blind, deaf, etc.)Medical ConditionBonded PairWhy are you interested in fostering a senior dog?What type of personality and activity level would you be able to care for?Name of Vet, and their phone numberResidenceSingle-family homeTownhouse or CondoApartmentOwnershipOwnRentLive with relative / friendType of yardFencedUnfencedNo yardNumber of children in the home aged 0-10Number of children in the home aged 11-18Number of adults in the homeIs anyone in the home allergic to pets?NoYesOther pets in the home: list names, ages, and breedsWho will be primarily responsible for the care of this dog?On average, how many hours a day will the dog be left alone?When you are NOT home, where will the dog stay?Fenced yardCrate in the houseLoose in the houseGarageOn a tie outsideIn one room in the houseOtherWhen you ARE at home, where will the dog usually be?Fenced yardCrate in the houseLoose in the houseGarageOn a tie outsideIn one room in the houseWith meOtherWhere will the dog sleep at night?Fenced yardCrate in the houseLoose in the houseGarageOn a tie outsideIn one room in the houseWith meOtherWhat sort of daily exercise will the dog receive?What circumstances might make you decide to return the dog?New jobNew babyChewing / scratchingPotty training difficultiesConflict with other petsIllnessAllergiesAggressionExcessive barkingMoving to new placeFinancial issuesOtherHow will the dog be taken care of if you are not in town?Would you accept an animal with a treatable medical condition?YesNoDependsDo you understand that Shep's Place retains sole responsibility for and ownership of the dog?YesNoDo you understand that Shep's Place may require the dog to be returned for whatever reason they choose?YesNoAre you willing to return the dog to Shep's once a month for a wellness check?YesNoAny other comments or concerns?PhoneSubmit
