Small Breed Rescue of East Tennessee

Name(s):

Home phone:    Work phone:

Email address:

Home address:

Mailing address (if different):

Do you  own or  rent?

Do you have the permission of your landlord to have a dog? Yes     No

If Yes, up to what size?

Do you have specific requirements regarding dogs you wish to foster? Yes     No

Specific dog:

Breed/size:

Gender preferred: Either Female Male

Age desired: Specific (please specify ->) Any Baby Young Adult Senior     Specific age:

Would you consider a Special-Needs Rescue Animal such as one who requires medication for a permanent but controlled condition? Yes     No

Please tell us why you want to foster a Dog:

Do you have any children, currently expecting a child or planning for a child? If yes, please give their ages. (Please note that we try to be as careful as we can when placing dogs in foster homes, especially when children are present, but we often have limited information regarding a rescue animal's history or temperament.)

Have child(ren)   Age(s):
Currently expecting a child
Planning for a child
No children
Not currently expecting a child
Not planning for a child

Does anyone in your household have allergies to dogs? Yes     No

May we visit your home prior to application approval (by appointment)?

Yes   When?
No

Do you currently have other animals? Yes     No

If yes, please list type of animal, age, and sex:


Have they ever been around other animals? Yes     No

Do they get along with other animals? Yes     No

Do your pets have any characteristics that we should be aware of that would affect an animal coming into the home (i.e., is your pet aggressive toward other animals, etc.)?

Yes

Please describe the characteristic(s):

No

Where will the dog be during the day?

How many hours will this pet be alone during the day?

Where will the dog be at night?

Is your yard fenced in?

Yes     If Yes, what type and height?
    

No     In No, please describe how you plan to confine your dog to your property when outside:
    

Do you have a swimming pool? Yes     No

If Yes, do animals have free access to it? Yes     No

Please provide the full name, address, and phone number of your current veterinarian:

May we contact your vet for a reference? Yes     No

Have you or any members of your family/household been cited for leash law violations or cruelty to animals in the past? Yes     No

If Yes, please specify:

I/We attest that the Terms and Conditions of Adoption as stated below have been read in full by me/us and I/we understand that is part of the foster process and will be enforced.

  I/We attest that the information provided on this application is true and accurate to the best of my/our knowledge.

  I/We understand that completion and submission of this application does not guarantee placement of a Rescue Animal.

  I/We understand that any misrepresentation of fact may result in the removal of the foster dog from my/our home.

  I/We understand that in the event we wish to adopt any SBRET rescue animal I/we will be required to follow the same adoption process as required by all individuals requesting to adopt an animal from SBRET.

Yes     No