Adoption Form

APPLICATION TO BECOME A FOSTER CARER FOR RESCUE HUB INC
Please fill in the details and then click the SEND APPLICATION button at the end
Name of Applicant/s:*

First NameLast Name
First NameLast Name
Residential Address (No PO Boxes):*

Street Address

Street Address Line 2

CityState

Postcode
Home Phone Number:*

Area CodePhone Number
Mobile Phone Number:*
E-mail Address:*
Please click on the appropriate response
Have you owned a dog before?*

YesNo
If yes, please specify breeds owned and how long each dog was with you.*
Please let us know whether you prefer a male or female dog*

MaleFemaleDoesn't matter
Are you employed?*

Full timePart-timeUnemployedPensionerRetiredStudent
How many adults live in your household? *
How many children live with you and what are their ages?*
How many hours a day will the foster dog be home alone?*
Do you have other pets?*

YesNo
If yes, please specify type / breed / sex and whether desexed*
Would you consider fostering a dog who has sustained an injury or who suffers from an existing illness/disability?*

YesNoDepends on the illness/disability
If a previous dog owner (any breed), how long did you own this dog?*
Where is this dog now? *

At homeHeavenRe-homedSurrendered to a shelter
If rehomed or surrendered - for what reason? Please elaborate*
In your opinion, which of the following circumstances justifies surrendering a pet? You may check one or more*

Moving housePersonality clash with another petEscaping from your yardChildren have lost interest and no longer take responsibilityToo time consumingOngoing medical problemsFears for the safety of a new babyDivorce / Partnership break-upCoat sheddingFinancial problemsToilet training problemsExcessive barkingFear of pet being lonely while you're away from the homeNone of the above - a pet is for lifeOther
Your home:*

HouseTown House/VillaApartmentUnit FlatAcreage
Do you:*

OwnRent*Live with parents**
Do you have secure fencing (at least 1.8m high)?*

YesNo
Approx. size of fenced area where your dog will have access and be secure:*
Do you have a dog door? *

YesNo
Is your motor vehicle air-conditioned? *

YesNo
Do you have a pool?*

YesNo
Is it fenced? *

YesNoNot applicable
If not fenced, does the pool have steps or a ladder to get out?*

StepsLadderN/A
Where do you envisage your dog will sleep?*
All reasonable costs for your foster dog will be covered by the Rescue Hub but we would still like you to answer the following questions so we can ensure any foster dogs entrusted to you are properly cared for.
Do you pledge to have your foster dog vaccinated, wormed and heart-wormed at the required intervals?*

YesNo
Do you pledge to purchase products that will keep your foster dog flea and paralysis tick free?*

YesNo
Do you pledge to seek Veterinary treatment when required?*

YesNo
Do you pledge to return the foster dog to us if you encounter any difficulty?*

YesNo
Do you pledge to love and care for your foster dog and consider his/her needs to be of supreme importance?*

YesNo
Would you allow your foster dog to come inside?*

YesNo
Sometimes it may be necessary to have the foster dog desexed. Would you be prepared to take the dog to a nominated vet to have this done and then care for the dog while he/she recovers?*

YesNo
Your foster dog may have training requirements. Do you pledge to work with our behaviourist and implement his training methods? *

YesNo
Would you agree to allow us to visit you at your home prior to approval as a foster carer? *

YesNo
Would you object to an occasional phone call from us to inquire about his/her well-being?*

YesNo
Please let us know why you would like to become a foster carer:*
Is there anything else that we should know to help us assess your application?*
IMPORTANT - PLEASE MAKE SURE YOU READ CAREFULLY
As much as we hate "small print", it is necessary to ensure that you are fully aware of your responsibilities when accepting a foster dog and we would ask that you read the following statement carefully.
Rescue Hub does its best to assess a dog before it is accepted as a foster but please remember that we have no knowledge concerning the background or previous environment of the dog (if obtained from a shelter) and have only the word of the previous guardian/s concerning the background or previous environment of the dog (if from a private home). While Rescue Hub is very happy to support you while you foster any dog/s, both financially and with advice (if needed), we do need to stress that once a carer decides to accept a foster dog, then they do so at their own risk.
I/We realise the commitment that I am/we are making to any foster dog I am/we are entrusted with and pledge to care for him/her as if he/she were my/our own. I/We understand that I/we once I/we decide to accept a foster dog that I/we do so at our own risk.*

AgreeDo NOT agree
Name of your usual veterinarian:*

First NameLast Name
Phone Number of your usual veterinarian:*

Area CodePhone Number
Names and numbers of two (2) personal referees*
I/We agree to relinquish any foster dog if it is established that I have given false or misleading information in this application OR if allegations of abuse or neglect are reported to Rescue Hub or any other animal welfare agency.*

AgreeDo NOT agree
Thank you for submitting your application.
Rescue Hub will carefully consider all the information you have submitted and
will contact you should there be any further details needed.
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APPLICATION TO BECOME A FOSTER CARER FOR RESCUE HUB INC