Foster Home Volunteer Form

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PART 1: Personal Information

First Name *

Last Name *

Street Address *

City, State, Zip *

Phone 1 *

Phone 2

Email *

NOTE: All Foster Homes must join our Yahoogroups Email list and check in at least once a day. Will you comply?

Household: Number of Adults

Number of Adult Females *

Number of Adult Males *

Children (Number and Ages)

Female Children *

Male Children *

Other Explanation

Ownership Status *

Own

Rent

Rentals require proof of landlord permission to foster dogs. Please send letter from Landlord on letterhead with phone contact information.

PART 2 Environmental Information

Yard Size *

Yard Securely Fenced? *

Yes

Describe Fence (height, mat’l) *

If fenced describe type of gates

Are gates padlocked?

Yes

Is there a swimming pool or spa? *

Yes

How would you protect the dog from drowning?

Are you aware of any dangers to the dog inside the fenced area? *

SLEEP: We require the dog NOT sleep in your bed. We prefer a crate or ex-pen.

Any Concern with the dog not sleeping in your bed? *

Where will the crate(s)/pen(s) be located? *

We require the dog be crated or in an ex-pen when you are away from the home or unable to supervise.

Any concern with the dog being crated or in an ex-pen when you are away from the home or unable to supervise? *

SMOKING: Does anyone in your home smoke? *

Yes

If you answered yes to smoking, how will you protect the dog from second- hand smoke?

The dog must be an “indoor” dog. Any concern? *

Do you have basic equipment? (e.g., crate, bowls, ex-pens, etc.) Note: We will supply the items, if needed. *

Yes

How long will the dog be alone (no humans) on a daily basis? Note: Working is okay as long as they have quality time when you are home. *

We require frequent large digital photos of the dog. Do you have a digital camera and know how to download and transmit? *

Yes

PART 3: Your Pets (For foster/babysitting volunteers)

(Past Dogs)

Have you ever had a Westie? *

How long and what happened to him/her? *

(Current Dogs)

How many current dogs? List names, ages, and breeds *

Other current Pets? List *

Have you ever fostered for another organization? *

Yes

Other organization details

Other Foster Animals (not ours) at current time? #, breeds

Are all pets altered? *

Yes

If yes, explain

If needed, can you isolate the dog? *

Yes

How do you think your current pet(s) will react to the rescue? *

How will you deal with it, if the reaction is bad?

PART 4 Foster Preferences

What areas are you willing to cover if the dog requires transportation?

Entire State

Metro Area

Lower Peninsula Only

Other

If Other above list details

What type of Westies will you take?

Males

Females

Puppies

Health Issues

Further Westie type details

In an emergency would you take others that did not fit the criteria above? *

What type of Westies will you take? *

Males

Females

Puppies

Health Issues

What Medical limits will you impose in taking a foster dog? *

Do you agree with the policy to neuter/spay ALL rescue dogs? *

Yes

If you do not agree, explain

How many dogs will you foster at one time? *

Will you do basic training while it is in your care? (e.g., sit, stay, etc.) *

Yes

How do you discipline a dog? How will you deal with a behavior problem? (e.g., dog aggression, house soiling, etc.) *

If your vet is unwilling to perform the procedures and or tests that Westie Rescue requires, are you willing to take the foster dog to a different vet? *

Yes

PART 5: Tough Decisions

Would you be able to handle it if a dog you are fostering has to be euthanized due to illness? *

Yes

Would you be able to handle it if a dog you are fostering has to be euthanized due to temperament? *

Yes

How would you handle it if it bit someone else? *

PLEASE NOTE: We are unable to place a dog who has bitten an adult and broken the skin. We will almost surely have to put it down. Therefore it is essential that we be very careful and not put a frightened dog into a position where it might bite if it is avoidable. (Note: We do our best to not accept aggressive dogs but it could happen. See our limitations statement under the Surrender Button on the website.

Would you be able to deny an adoptive family a particular dog because the placement “didn’t feel right”? *

Yes

Do you have the support of all home residents in fostering? *

Yes

How would you handle vacations and other “time off” while you had a foster dog? *

Are you willing to work closely with Rescue in making any placements? *

Yes

Are you financially able to provide adequate food? (Rescue pays all authorized medical care.) *

Yes

How will you prepare yourself for the day the dog goes to the new family? *

Are you willing to stay in contact with the adoptive home to ensure the placement was a success, including follow up visits and/or phone calls? *

Yes

After placement, the home decides to return the dog. Will you act quickly to get the dog back into foster care? *

Yes

Are you willing to provide counseling resources to the adoptive family should problems arise later on in the placement? *

Yes

Your comments and suggestions

Part 6 References

REFERENCE 1: VETERINARIAN

Name *

Phone *

REFERENCE 2: PERSONAL REFERENCE

Name *

Phone *

Relationship *

REFERENCE 3: PERSONAL REFERENCE

Name *

Phone *

Relationship *

By submitting this form, I attest that, to the best of my knowledge, the above information is accurate and complete at the time of signing, and I understand that falsely provided information can mean that my application will be terminated.

Note: You are advised to consider carrying an individual umbrella liability policy of at least $1 million; it is a very inexpensive form of protection. While we have never been sued for anything related to rescue, it is always better to be protected. Also, be sure your own dog’s shots are up to date, including Bordetella and that your dog is on a heartworm preventative. If you are fostering, you might want to consider using a brand such as Sentinel which kills various internal parasites that new fosters might bring in. A photostatic copy of this executed document shall be considered as valid as the original.