First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone*

Alt Email

Text/Pager Email

What is your date of birth? (**We DO NOT adopt or allow someone to foster under 21 years of age**)*

Do you own your home, rent your home or live with your parents? *
Choose one: Live with Parents Own Rent

If rental, is it seasonal?
Choose one: Yes No

If renting, please enter your landlord's name and phone number. If you are living with family/parents please provide a contact for the home owner.

Do you currently have any pets?*
Choose one: Yes No

If yes, please provide the name, phone # & address of veterinarian.

Name, type of animal, age and gender for current pets.

If you own dogs, are they licensed?
Choose one: Yes No

Are these pets up to date on their shots?
Choose one: Yes No

Are these pets Spayed/Neutered?
Choose one: Yes No

Have you owned any animals in the past?*
Choose one: Yes No

If yes, list pets previously owned. Please include name, breed, gender and what happened to the pet.

Have any of your animals ever been picked up by animal control? If yes, when?*

Have you ever surrendered an animal to animal control? If yes, when?*

Have you ever been charged with a violation of Town or State Animal Control Laws?*
Choose one: Yes No

Will the animal you are looking to foster be kept inside or outside?*

Do you have a fenced in yard?
Choose one: Yes No

Approximately how many hours a day will this animal be alone? *

Please list all members of your household other than yourself. Please include their relationship to you and their ages.

Please provide NON-FAMILY reference, including name, phone # and their relationship to you.*

Would you be willing foster an animal who is exhibiting a cough or the sniffles and provide compassionate and loving care along with administering medications provided by the rescue? Please elaborate.*

Would you be willing to foster an animal who has loose stool or diarrhea and provide compassionate and loving care along with administering any medications provided by the rescue? Please elaborate.*

Would you be willing to foster a dog that is exhibiting trouble socializing with other animals, provided the rescue provides professional help with introductions and socialization techniques? Please elaborate.*

Would you be willing to foster an animal who will need extra attention for behaviors associated with fear or lack of socialization? Please elaborate.

Are you willing to foster an animal who may need to be isolated from other animals because of health issues like ringworm, mange, or kennel cough? Please elaborate.*

Would you be willing to foster an animal who is dirty, scared, and withdrawn? Providing a flea bath and a warm meal and unconditional love and guidance?? Please elaborate.*

Many animals have spent their life chained to a tree or a dog house… Or wandering the streets alone and scared. Would you be willing to help teach a dog about the manners required for “house living”? Please elaborate.*

Many animals have never been walked on a leash…would you be willing to assist in teaching an animal the joys of going for walks “safely” on the end of a leash? Please elaborate.*

Experience has taught us that our weekly Adoption Events are the prime reason for our success in getting these animals adopted. Are you willing to participate in getting your foster dog to and from our weekend events? Please elaborate.*

Animals are creatures of habit. Are you sensitive to how difficult and stressful this transition can be on them, and are you willing to commit to helping them to transition to all the changes by providing them with a secure home for a minimum of one week? Please elaborate.*

Animals are very much like humans when it comes to meeting new friends of the 2-legged and the 4-legged version… First time interactions can be scary and stressful. Do you understand that these “reactions” are not a true indication of the animals nature, and that you will have to be patient and strong in leading the dog to behave appropriately? Please elaborate.*

95% of all dog fights are brought on by toys, and treats such as raw hides. Are you committed to making sure that these items are not “laying around” to avoid any potential conflicts? Please elaborate.*

Many animals will chew on inappropriate items when they feel nervous or stressed. Besides having your things damaged or ruined, this can sometimes be dangerous to the animal. Would you be comfortable kenneling the animal in a size appropriate crate when left unattended? Please elaborate.*

Exercise is a VERY important component to “balancing” out dogs energy levels, and can also help to curb unwanted behaviors. Are you able to commit to making sure that your foster animal receives adequate exercise? Please elaborate.*

As a volunteer based organization, are you committed to helping us properly plan for any changes to your commitment by giving us ample notice when an animal needs to be moved to a new home? Please elaborate.*

In case of an EMERGENCY or if an UNDESIRABLE or CHALLENGING situation arises, Last Chance Volunteers will do their best to respond in a timely manner however we ask that you respect that we also have families, jobs and lives outside of the rescue work. Please try to be resourceful and responsible by considering the following actions:

• Stay calm. Animals can be unpredictable by nature. We know all too well that animals can create challenging situations that will put us all to the test. The best thing you can do is STAY CALM!
• Crate the animal, in a size appropriate crate/kennel, and walk the animal separately from other animals in the household until other accommodations can be made.
• Move the animal to a spare bedroom, bathroom, garage, etc until other accommodations can be made.
• For minor flesh wounds, bumps, or rashes… please consider whether a warm compress, Povoiodine, and/or some Neosporin might do the trick.
• Check with Google to see if you can come up with a reasonable resolution to the problem/situation.

I, hereby acknowledge the following policies and agree to abide by them during the entire time I am fostering dogs for LCAR. I understand that my role is solely as a temporary home, and that the placement of any dogs I foster will be conducted by LCAR. It is the job of an LCAR representative to review and interview potential adopters, BUT as the foster, I will make the dog available to be shown.*
Choose one: Yes No

I understand that I am personally responsible for any and all financial expenses that I incur in my efforts to foster dogs for LCAR. Although LCAR may choose to reimburse my expenses, I agree that each expense must be supported by receipts, must be pre-approved by the LCAR Rep, and any expense over $200 for a single dog must also be pre-approved by the Board of Directors. I accept full responsibility for any expenses incurred by me that fall outside of approved expenditures. I will always remember that I represent a nonprofit organization and in no way can profit from any activity related to the organization.*
Choose one: Yes No

I understand that LCAR cannot guarantee or be held responsible for the temperament, behavior, or health of foster dogs that I may handle. I am aware that foster dogs may cause damage to my personal property, other pets, and humans and agree sole responsibility for these occurrences. I will keep dog/s securely contained at all times while in my care.*
Choose one: Yes No

I understand that it is my decision to foster dogs for LCAR. I will not hold LCAR liable for any damage, injury or harm caused directly or indirectly through my fostering activities with LCAR. I carry insurance coverage in the event of personal or liability damages resulting from fostering animals for LCAR.*
Choose one: Yes No

I understand that should I decide to keep the dog, that I will have to apply to LCAR with an Adoption Application and pay $600 - all dogs , $300 - for dogs deemed seniors by LCAR (generally 7yrs and older) and $150 - for senior citizens (over 65 yrs of age) adopting senior dogs. *
Choose one: Yes No

I understand and agree to all of the above, and support the mission of LCAR. I understand that this form must be received, approved, and acknowledged by LCAR before I may do any volunteer work for the organization, and that LCAR reserves the right to refuse my application. Home Visit: You agree that one or more home visits may be made with or without prior notice, and I hereby agree to this. LCAR may examine and/or make inquires about the dog at any time. If LCAR is not satisfied with the manner in which the dog is being kept the dog may be immediately reclaimed. Reclaiming of the dog shall not be considered a trespass or theft. Application: All of the information I/We provided in this application is true and correct. If any of the information changes, I/We will advise you promptly. *
Choose one: Yes No

Please provide Drivers License #, State of issue and Expiration date.*