Please enable JavaScript in your browser to complete this form.Name of Dog You Wish to Adopt *Name *FirstLastDate *Address *Address 2City *State *Home Phone *Daytime PhoneCell PhoneEmail *Number of Adults (over 18 years) *Number of Children (under 18 years) *Ages of childrenWho in the household will be the pet’s primary caregiver? *Have allergies to animals been a problem to any household member? *YesNoIs shedding a concern? *YesNoAre all family members aware that you are considering adopting a pet? *YesNoDo they all approve? *YesNoDo You Live In : *HouseCondo/TownhouseApartmentDormDo you rent or own your home? *RentOwnLive with ParentsWhat best describes your street location: *CityBusy TrafficResidentialVery Little TrafficOtherIf other, please describe.What is your employment status? *Full TimePart TimeStudentRetiredOtherIf other, please provide details. The cost of caring for one dog is at leat $500/year. This includes food, litter, vaccines, flea treatment and vet bills. Are you able and willing to pay this cost? *YesNoHow many pets do you have now? *Number of Dogs *Number of Cats *Other Pets? Please provide type and number.Are they current on their vaccinations? *YesNoIf you own dogs, have they been socialized with cats?YesNoName of current veterinarian: *For what reasons would you like to adopt this dog? *Pet/FriendHuntingGuard/Protection/Watch DogCompanion for Other PetOtherIf other, please explain.Do you have a fence? *YesNoWhat type of fence?WoodChain LinkBrickOtherHeight of the fence.Will this dog be *IndoorOutdoorBothWhere will this dog be when you are home? *Where will this dog stay when you are away? *Where will the pet spend most of its time? *CrateIndoorsOutdoorsBasementRunOtherIf other, please describe.Where will your new pets main sleeping quarters be?CratePet BedShare Bed with OwnerOutsideDesignated RoomGarageBasementWhich of the following reasons would prompt you to give up your dog? (choose all that apply) *Excessive BarkingBiting/Scratching Family MemberPoor Guard DogPlanning on Having a BabyAllergiesNot Friendly with Guests (barking, hiding)Aggressive with Dogs/CatsNew Spouse/Partner doesn't Like DogBitingChewing on Furniture or CarpetDivorceSheddingFinancial ProblemsWon't always go outside to peeExcessive Veterinarian BillsAggressive with other dogsDog's Health ProblemsNone of the AboveAgree to Terms *I hereby agree to the terms and conditions below.By checking the box below, I agree to the following terms regarding my participation as a Foster Parent for Rez Animal Resources & Education: I agree to provide a temporary home for animals placed in my care and will be responsible for providing daily food, water, exercise, shelter, and affection for my foster animal. I agree to let Rez Animal resources & Education inspect the premises where the animal is being kept at any time to ascertain that the animal is well cared for. In the case of a medical emergency, I will contact Rez Animal Resources & Education and obtain immediate veterinary care at the approved clinic. If I encounter behavior concerns with my foster animal, I will contact Rez Animal Resources & Education. I understand that foster animals often have unknown medical and behavior histories and may show behaviors in one home that they may not show in another home. I agree to work through these issues to the best of my ability. If concerns are beyond my ability, I will work with Rez Animal Resources & Education to find a more appropriate foster home. I understand that animal bites or other injuries to humans and other animals do occur, and agree to hold harmless and indemnify, and protect Rez Animal Resources & Education, from any claim or suit filed by anyone as a result of such an incident. In addition, Rez Animal Resources & Education will not be responsible if the animal should damage or destroy property while the animal is under my care. If I need to return the foster animal before the end of the agreed-upon foster period I will contact Rez Animal Resources & Education at least 72 hours to find another foster home for the animal. If I have a known period of time (i.e vacation) that I cannot provide care for the foster animal, I will discuss options for my foster animal at least two weeks prior. All foster cats must be kept inside only. Foster dogs should be allowed indoors/outdoors but must be provided with a secure fenced area when outside, including shelter from the elements. The foster animal will always be under my control either on leash or in the confines of my property. I will not allow others to care for my foster animal unless I have received approval from Rez Animal Resources & Education to do so. I am responsible for the well-being of my foster animal at all times.DateSubmit