3 Acres Rescue Foster Application
Thank you for your interest in fostering with 3 Acres Rescue! Please fill out the following application
First Name
Last Name
Email
Phone Number
Address
Your date of birth
Do you live in a
Select an option
Single Family Home
Apartment
Condo/Townhome
Other
Do you own or rent?
Select an option
Own
Rent
Live with parents
Other
If you rent, landlord contact information
Household Setting
Select an option
Rural
Suburban
Urban
Describe your homes activity level
Select an option
Busy/Noisy
Moderate comings/goings
Quiet with occasional Guests
Please list all people living in the household, (Include Name, Relationship, Gender and Age)
Does anyone in your household have allergies to animals?
Select an option
Yes
No
Are all members of your family agreeable to fostering a dog?
Select an option
Yes
No
Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm, Living/Deceased)
Do you have a preference in sex of foster?
Select an option
Male
Female
No preference
Are you willing to foster a dog of any age?
Select an option
Yes
No
Yes, but no puppies
If not, what age would you consider?
What size dog are you willing to foster? (Check all that apply)
Small
Medium
Large
Other, (Answer Below)
Other
Please describe the type of dog you are willing to foster (Please include breed, coat length, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes.
Are you willing to take your foster dog to vet appointments at a convenient time for you?
Select an option
Yes
No
Do you drive or have access to a vehicle to bring your foster to events and appointments?
Select an option
Yes
No (if no please explain)
Do you drive or have access to a vehicle to bring your foster to events and appointments?
Are you willing and able to medicate your foster, even if it just a monthly heartworm preventative?
Select an option
Yes
No
Are you willing to foster a heartworm positive dog?
Select an option
Yes
No
Are you willing to foster a dog with disabilities?
Select an option
Yes
No
We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?
Select an option
Yes
No
Have you had any experience with an emotionally or physically neglected or abused dog?
Select an option
Yes
No
Have you had any experience with an emotionally or physically neglected or abused dog?
Are you willing to use a crate for a dog if recommended?
Select an option
Yes
No
If fenced, please give details on height, material, # of gates, are gates locked or lockable?
How many hours in a day would the foster be left alone?
What are your plans to exercise your foster? Please list any parks nearby or trails, how many walks a day, approximate length, and activities such as agility.
Vet Reference: Full Name
Please list two personal references with names, addresses, phone numbers and how related. We prefer it not to be relatives.
Reference #1
Reference #2
By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.
I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any 3 Acres Rescue animal fostered by me. I certify that the above information is correct, and I understand that the information will be verified. I understand that by submitting this form electronically, I agree to release and covenant to hold harmless 3 Acres Rescue/Marliana Mullis and its members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog. I accept full responsibility for the dog(s) actions at all times and release 3 Acres Rescue/Marliana Mullis from any liabilities or damages that may be incurred because of fostering such dog(s). I agree to have 3 Acres Rescue/Marliana Mullis complete reference call checks and conduct a home visit inspection to be able to approve my foster application. I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to 3 Acres Rescue/Marliana Mullis and try to give 3 Acres Rescue/Marliana Mullis a 2 week period to try and find another suitable foster for the dog(s).
Disclaimer
I recognize that working with animals places me at physical risk, and I agree to assume that risk. 3 Acres Rescue/Marliana Mullis has taken measures to ensure reasonable safety for me as a foster. It is possible, however, that accidents, injuries, or property damage may occur while I am fostering for 3 Acres Rescue/Marliana Mullis. In such an event, I release 3 Acres Rescue/Marliana Mullis from any and all claims and causes of action that I may have arising from an injury, health issue, or damage sustained. I agree that I will respect the positions and policies of the organization. While personal opinions regarding care and other issues may vary, I will follow the positions and policies set out by 3 Acres Rescue/ Marliana Mullis as a foster and representative of the organization.
Your Signature
*
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