Foster Application | Hogar Temporero

Full Name /Nombre Completo*

First Name / Primer Nombre Last Name / Apellido

Age / Edad*

E-mail / Correo electrónico*

Address / Direccón Física*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home / Teléfono Casa*

Area CodePhone Number

Phone Number - Cellular / Teléfono Celular

Area CodePhone Number

Phone Number - Work / Teléfono Trabajo

Area CodePhone Number

Do you live in a: / Vives en:*

Do you: / Es:*

Own / PropiaRent / RentadaLive with Parents /Vives con PadresOther / Otro

If Renting: Please indicate landlord contact information

Household Setting / Ubicación de la propiedad

Rural / Area RuralCity / Ciudad

Describe the Activity Level in your Home / Describir el nivel de actividad en su hogar

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests / Tranquilo con ocasionales huéspedes

Please List all People Living in the Household (Include Name, Relationship, Gender and Age / Por favor Enumere todas las personas que viven en el Hogar (Incluir nombre, relación, sexo y edad))*

Does Anyone in your Household have Allergies to Animals? / ¿Alguien en su hogar tiene alergias a los animales?

Yes / SiNo / No

Are all members of your Family agreeable to Fostering a Dog? / ¿Todos los miembros de su familia estón de acuerdo con que de hogar temporero a una mascota?

Yes / SiNo / No

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm, Living/Deceased) / Por favor, Detalle las mascotas usted tiene viva o muerta (Por favor incluya nombre, raza, edad, operada, Sexo Vacunas, gusano del corazón,Viva / Fallecido)

Would you be willing to have a Huellitas Caidas del Cielo Team Member call your veterinarian for a reference check? (Please authorize vet to speak with us) / ¿Estaría usted dispuesto a tener una llamada Huellitas Caidas del Cielo Miembro del Equipo a su veterinario para un cheque de la referencia? (Por favor, autorizar veterinario para hablar con nosotros)

Yes / SiNo / No

Veterinarian Name / Nombre del Veterinario

First NameLast Name

Address / Dirección

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number / Telefono

Area CodePhone Number

Do you have a preference in the sex of foster? / ¿Usted tiene una preferencia en el sexo de la mascota?

Male / MachoFemale / HembraNo Preference / Ninguna Preferencia

Are you willing to foster a dog of any age? / ¿Estás dispuesto a cuidar un perro de cualquier edad?

Yes / SiNo / No

If not, what age would you consider? / Si no, ¿qué edad considera usted?

What size dog are you willing to foster? (Check all that apply) / ¿Qué tamaño de perro está dispuesto a cuidar? (Marque todo lo que corresponda)*

Small / PequeñoMedium / MedianoLarge / Grande

Are you willing to take your foster dog to vet appointments at a convenient time for you? /¿Está usted dispuesto a llevar a su perro de guarda a las citas del veterinario en un momento conveniente para usted?

Yes / SiNo /No

If No please explain / Si es No Explique

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience? / No podemos garantizar que un perro este domesticado, ¿está usted preparado para entrenar con el amor y la paciencia?

Yes / SiNo / No

Have you had any experience with with an emotionally or physically neglected or abused dog? /¿Ha tenido alguna experiencia con con un perro emocionalmente o físicamente descuidado o maltratado?

Yes / SiNo / No

If Yes please explain / Si es si explique

Do you have a fenced yard? / ¿Tiene un patio cercado?

Yes / SiNo / NoPartial / Parcial

How many hours in a day would the foster be left alone? /¿Cuántas horas en un día la mascota se deja solo?*

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Huellitas Caidas del Cielo animal fostered by me.I certify that the above information is correct, and I understand that the information will be verified.I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Hullitas Caidas del Cielo and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog.I accept full responsibility for the dog(s) actions at all times, and release Huellitas Caidas del Cielo from any liabilities or damages that may be incurred because of fostering such dog(s).I agree to have Huellitas Caidas del Cielo complete reference call checks and conduct a home visit inspection to be able to approve my foster application.I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to Huellitas Caidas del Cielo and try to give Huellitas Caidas del Cielo a 2 week period to try and find another suitable foster for the dog(s). /

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MonthDayYearHourMinutesAM/PM Option

Your name / Tu Nombre *

Comments / Comentarios*