Name of desired dog:
Your name:
Your occupation:
Spouses name:
Spouses occupation:
Name/ages of children:
Other occupants in home:
Home address:
City:
State/province:
Zip/postal code:
Home phone:
Mobile phone:
E-mail address: (valid email is required)
Your age:
Age 18-21
Age 22-26
Age 27-32
Age 33-45
Age 46-55
Age 55-70
Age 71+
Type of dwelling:
House
Condo
Apartment
Other
Do you personally rent or own?
Rent
Own
If renting, do you have landlords permission to have a dog?
Yes
No
Is there a size/weight limitation? What is it?
Landlord’s name and phone number:
How long have you resided at this location?
Primary reason for wanting a dog:
Companion for You
For Kids
For Other Pet
Watchdog
Other
If other, please specify:
If you have children, please describe their previous experience with dogs:
If your children did not want a dog, would you be interested in fostering one for yourself?
Yes
No
Does anyone in your household have allergies? If yes, describe:
Do you have a pet now? How many?
List type of pets (if dog, list breed); age(s) and sex(es):
How long owned?
Where did you get your current pets?
Do your animals have any physical issues?
Do your animals have any behavioral issues?
Do your animals get along with (other) dogs?
Have you ever had multiple dogs in your home?
Yes
No
How did you feed them?
Next to Each Other
In Same Room
Separated
Free Feed
Other
Did you have toys and/or bones around?
Yes
No
Are your pets spayed/neutered?
Yes
No
Have you ever allowed an animal to breed?
Yes
No
Have you ever had to surrender an animal to a shelter or rescue group?
Yes
No
If yes, please explain:
Is there anybody home during the day? Who?
When will the dog be inside? Outside?
About how many hours will the dog be left alone?
Where will the dog stay when he/she is home alone? (please be as specific as possible; i.e. run of the house, a specific room, a crate, etc.)
Where will the dog sleep at night? Doghouse, garage?
If inside, where exactly? Kitchen, master bedroom, spare room, laundry room, run of the house, other?
If other or if you have additional comments on where the dog will sleep, please specify:
What rooms are off limits to the dog?
What outside areas are available to the dog? (Select all that apply)
Fenced Yard
Enclosed Patio
Garage
Doghouse
Unfenced Common Area
Other
If other, please specify:
Do you have a doggie door?
Yes
No
Type of fencing? (Chain link, wood, block wall, etc.)
Height of fence? List highest point and lowest point:
I have recently inspected my fences and they are good condition:
Yes
No
The fence is intact on all sides and is at least 6 feet from the ground level in all areas:
Yes
No
I promise to inspect my fences thoroughly before the home visit and make necessary repairs for the safety and well being of our foster Pet:
Yes
No
Are there gates?
Yes
No
How many gates?
How high?
Is there any type of lock on the gate(s)?
Yes
No
Type of lock: (padlock, key, latch, etc.)
If no locks, would you be willing to install them prior to placement should this application be accepted?
Yes
No
Do you have a swimming pool?
Yes
No
If yes, is swimming pool surrounded by a gate?
Yes
No
Who has access to your yard? (Select all that apply)
Immediate Family Only
Gardener
Pool Man
Utility
Neighbor
Other
If other, please explain:
Preferred level of exercise with dog:
Couch Potato
Short Walks
Vigorous Walks
Hike or Jog Regularly
Dog Park
Other
How would you rate your level of dog owning experience?
First Time Owner
Beginner
Intermediate
Advanced
Other
If other, please explain:
How would you train this dog?
Obedience Class
Hit with Newspaper
Firm Verbal Commands
Clicker/Hand Signals
Other
If other, please explain:
How would you discipline your dog, if at all, if he or she misbehaved?
What, if any, behavioral issues have you dealt with in the past?
Dog Aggression
People Aggression
Leash Aggression
House Breaking
Separation Anxiety
Escaping
Fear Aggression
Have you ever had any of your own dogs get into a fight?
Yes
No
If yes, please explain
Would you be able to live with your dogs where you had to limit your affection?
Yes
No
How do you normally walk your dog? On leash, off leash
On Leash
Off Leash
When on leash do you normally use:
Collar Only
Corrective Collar
Harness
Other
If other, please specify:
If your dog escaped from your home, what steps would you take to find him/her?
Are you willing to live with hair on the furniture, stains on your rugs, a warm body on your bed, and an animal that might be destructive at times?
Yes
No
Which of the following reasons might prompt you to give up your dog? (Select all that apply)
Excessive Barking
Biting
Digging
Moving
Divorce
Baby
Illness
Not Getting Along With Other Pet
Poor Watchdog
Destructive Chewing
Financial Problems
Occasional Accidents Indoors
Growling at Guests
Excessive Vet Bills
Shedding
Allergies
New Spouse/Partner Does Not Like Dogs
Aggressive on Leash
None of The Above
Comments:
Please list pets you have owned since you have been an adult and the length of ownership; if they are no longer with you, please provide an explanation (died, gave away, etc): (please list type (breed/breed mix))
How did you find out about our foster program?
Why are you interested in fostering a dog from a rescue?
Please read and check each statement below
I understand that a home visit is required prior to final placement:
I understand that a home visit does not guarantee placement:
Yes
Yes
Karma Rescue reserves the right to refuse fostering to any applicant for any reason. This questionnaire becomes part of our contract:
I understand
Please list the name of the dog you're interested in again, and tell us why you're interested in this particular dog:
How did you find out about Karma Rescue?
Walk in
Referred by
Website
Petfinder/1-800-Save-a-Pet
Other
Please explain