RMCR Foster Application


	Foster Applicant Personal Information

*How did you hear about our organization?:

*Foster’s Name:

*Street Address:

Street Address 2::

*City:

*State:

*Zip Code:

*Home Phone:

- -

Cell Phone:

- -

*Work Phone:

- - x

*Email Address:

*How long have you lived at the present
address?:

(If less that five (5) years, please provide previous address)

Previous address:

Previous Address 2:

Previous City:

Previous State:

Previous Zip Code:

*Type of residence:

*Does your residence have a fenced yard?:

Yes

No

*Do you own or rent your residence?:

Own

Rent

If you rent, do you have your landlord's
permission to have a dog?:

Yes

No

Can you provide proof of that permission?:

Yes

No

If renting, be prepared to provide a copy of your lease or written approval from your Landlord for you to have one or more dogs at your residence.

Landlord Name:

Landlord Phone Number:

- -

Landlord Street Address:

Landlord City:

Landlord State:

Landlord Zip Code:

*Date of Birth of Primary Applicant:

*Marital Status:

*Your occupation:

Spouse's occupation:

*Do you have children?:

Yes

No

(If yes, please provide their names and ages)

Name of Child #1:

Age of Child #1:

Name of Child #2:

Age of Child #2:

Name of Child #3:

Age of Child #3:

Name of Child #4:

Age of Child #4:

If you have more than four children, please
list the other children's names and ages here:

*Have your children lived with or had exposure
to dogs?:

Yes

No

*Do you live with roommates?:

Yes

No

*If yes, are they in agreement with your
decision to possibly foster a dog?:

Not applicable

Yes

No


	Two Personal References (Non-related please)

*Reference #1 Name:

*What is your relationship with Reference #1?:

*How long have you known Reference #1?:

*Reference #1 Street Address:

*Reference #1 City:

*Reference #1 State:

*Reference #1 Zip Code:

*Reference #1 Home Phone Number:

- -	At least one phone number is required. If Reference #1 only has a cell phone, place the number here.

Reference #1 Cell Phone Number:

- -

Reference #1 Work Phone Number:

- - x

*Reference #2 Name:

*What is your relationship with Reference #2?:

*How long have you known Reference #2?:

*Reference #2 Street Address:

*Reference #2 City:

*Reference #2 State:

*Reference #2 Zip Code:

*Reference #2 Home Phone Number:

- -	At least one phone number is required. If Reference #2 only has a cell phone, place the number here.

Reference #2 Cell Phone Number:

- -

Reference #2 Work Phone Number:

- - x


	Veterinarian Information

List any veterinarian used in the last three years or the vet you will use if this is a first-time pet.

*Veterinary Clinic/Hospital Name:

*Veterinarian's Name:

*Veterinarian's Street Address:

*Veterinarian's City:

*Veterinarian's State:

*Veterinarian's Zip Code:

*Veterinarian's Phone Number:

- - x

*How long have you known this vet or
clinic/hospital?:

*How or why did you choose this vet/clinic?:


	Pet Information

*Do you currently own any other pets?:

Yes

No

If yes, how many?:

Please describe the animals.

Name of Pet #1:

Species and Breed of Pet #1:

Age of Pet #1:

Gender of Pet #1:

Male

Female

Is Pet #1 spayed or neutered?:

Yes

No

General traits of Pet #1:

Medical issues of Pet #1:

Name of Pet #2:

Species and breed of Pet #2:

Age of Pet #2:

Gender of Pet #2:

Male

Female

Is Pet #2 spayed or neutered?:

Yes

No

General traits of Pet #2:

Medical issues of Pet #2:

Name of Pet #3:

Species and breed of Pet #3:

Age of Pet #3:

Gender of Pet #3:

Male

Female

Is Pet #3 spayed or neutered?:

Yes

No

General traits of Pet #3:

Medical issues of Pet #3:

Name of Pet #4:

Species and breed of Pet #4:

Age of Pet #4:

Gender of Pet #4:

Male

Female

Is Pet#4 spayed or neutered?:

Yes

No

General traits of Pet #4:

Medical issues of Pet #:

Are all of the animals in your household
current on vaccinations?:

Yes

No

If not, why not?:

Are all of the animals in your home friendly
with children?:

Yes

No

Are all of the animals in your home friendly
with cats?:

Yes

No

Are all of the animals in your home friendly
with other dogs?:

Yes

No

If you answered "No" to any of the previous
three questions, please provide additional
information:

Please let us know which of your pets is not friendly and whether it is towards cats, dogs, and/or children.

Do any of the animals in your home have a
preference to men or women":

NA

Men

Women

Do any of the animals in your home prefer
opposite sex dogs only?:

NA

Male

Female


	Additional Foster Questions

*Are you willing to transport your foster to
and from vet and/or grooming appointments?:

Yes

No

*Are you willing to attend a behavioral class
prior to fostering and quarterly meetings
once you are fostering?:

Yes

No

*Are you willing to provide shelter, love,
care, and attention as if the foster dog was
your own dog?:

Yes

No

*Do you have a medium-sized crate?:

Yes

No

*If you answered "No" to the last question, do
you have room for a crate?:

Yes

No

*How many hours a day will foster animals be
alone?:

*Where will the dog be kept when you are not
home?:

*Are you willing to foster a special needs
behavior case?:

Yes

No

*Are there any behavioral issues you are
unwilling to work through?:

Yes

No

If you answered \Yes\ to the previous
question what behavioral issues are you
unwilling to work through?:

*Are you willing to foster a special needs
medical case?:

Yes

No

*Are there any medical issues you are
unwilling to work through?:

Yes

No

If you answered \Yes\ to the previous
question what medical issues are you
unwilling to work through?:


	Rocky Mountain Cocker Rescue Code of Ethics

As a volunteer for Rocky Mountain Cocker Rescue, I will agree to represent and promote their mission and policies in full.

As a volunteer for Rocky Mountain Cocker Rescue, I understand it is my responsibility to be educated about the Cocker Spaniels that this organization represents.

As a volunteer for Rocky Mountain Cocker Rescue, I will treat my fellow volunteers with respect and compassion.

As a volunteer for Rocky Mountain Cocker Rescue, I will have my personal pets up-to-date on all vaccinations (including Bordatella) and in good health prior to attending any public event or fostering for the organization.

As a volunteer for Rocky Mountain Cocker Rescue, I declare that any of my personal pets that I bring to public events are both human and dog friendly. I will take full personal responsibility for their behavior and actions.

As a volunteer for Rocky Mountain Cocker Rescue, I will not use choke chain, pinch collar or shock collars at any public event. The preferred alternative is a Gentle Leader, Easy Walk Harness or regular leash and collar or harness.

By clicking the Submit botton at the bottom of this Application, I certify that the information I have provided herein is true, correct, and complete to the best of my knowledge, experience, and belief, and that I have not concealed or failed to disclose any pertinent information herein. In addition, I understand that Rocky Mountain Cocker Rescue (RMCR) processes and evaluates applications based upon the information provided herein, and that RMCR will rely specifically and solely upon the truthfulness and completeness of the information I provide in this Application in deciding whether to accept and approve my Application. In the event that any provision of this Application becomes the subject of litigation, I agree to pay RMCR’s legal fees, costs, and expenses incurred in its enforcement. If any provision of this Application is found to be unenforceable, all others shall remain legally binding.


	Foster Application Acknowledgment

By clicking the Submit button at the bottom of this Application, I, the Undersigned foster applicant, acknowledge that I am willing to take a foster dog from Rocky Mountain Cocker Rescue (RMCR) into my home and care for this foster dog on a temporary basis. I understand that the exact nature of any foster dog may not be known, whether through the nondisclosure of previous owners or otherwise. I understand that while every attempt is made to learn as much as possible about every dog received by RMCR, it is possible that damages, losses, or other injuries may result to me, my real or personal property, other pets, and/or other individuals, and I accept and assume these risks.

By submitting this Application, I acknowledge that RMCR shall not be responsible for any damages, losses, or other injuries to person, pet, or real or personal property caused by any foster dog received by RMCR. If this Application is accepted and approved, I hereby assume sole responsibility for, and agree to release, indemnify, defend, and hold RMCR, its officers, directors, members, employees, representatives, agents, volunteers, other foster parents, and assigns, past or present, (“the Releasees”) harmless for any and all damages, losses, and other injuries (including legal fees, costs, and expenses), to person, pet, or real or personal property arising out of, associated with, or in consequence of the placement of a foster dog, howsoever such damages, losses, or other injuries to person, pet, or real or personal property may be caused and regardless of fault, negligence, or liability of the Releasees or others.

I also acknowledge that I will be required to sign a hard copy of this form before I will be allowed to foster any animal for Rocky Mountain Cocker Rescue, Inc.