HOME
Find a BEST FRIEND
HELP the Dogs
JOIN the TEAM
HAPPY Tails
Friends of MomsVA
HOME
Find a BEST FRIEND
HELP the Dogs
JOIN the TEAM
HAPPY Tails
Friends of MomsVA
MomsVA Animal Rescue
Foster Parent form
Thank You for your interest in fostering a rescued canine orphan.
Please give yourself ample time to complete this form. Our goal is to match rescued orphaned dogs with foster parents who can best help them transition to forever homes. Please allow 3-5 business days for a MomsVA representative to review your completed form and contact you.
This form is confidential
:
This form is designed to help you find the dog or puppy most compatible with your lifestyle. MomsVA will maintain the information provided below as confidential and will not share your information with any outside individuals or organizations without your express consent. Completion of this application does not obligate you in any way or guarantee the fostering of a MOMS dog or puppy. MOMS reserves the right to approve or deny any foster parent volunteer request for any reason and the right not to disclose the reason.
Please complete all the following questions completely to the best of your knowledge.
Applicant information
*
Indicates required field
Name(s) & Breed(s) of the dog that interest you:
*
Your Name
*
WORK Phone Number
*
HOME Phone Number
*
CELL Phone Number
*
Are you over 18 years of age?
*
Yes
No
Are you over 70 years of age?
*
Yes
No
BEST contact number
*
WORK Phone
HOME Phone
CELL Phone
Email Address
*
Your Address (city, state, and zipcode)
*
Your Occupation
*
Your Employer's Name
*
Employer's Address (city, state, and zipcode)
*
Household Information
Names of other adults in your household
*
Names & Ages of children in the household
*
Other Adult's Occupations (include employer name(s) and addresses)
*
Are you aware of your county's or city's number of allowed pets?
*
Yes
No
Who will be the primary caregiver for your foster dog/puppy?
*
Who is (or will be) financially responsible for the pets in your home?
*
Is this the first dog for you and your family?
*
Yes
No
Are all the adults in your household aware that you want to foster a dog or puppy?
*
Yes
No
Planning as a surprise/Gift
Does any member of your household have pet allergies?
*
Yes
No
Not Sure
Current pets?
1) Other pet in the House (Name, Breed, Age)
*
Gender
*
Male
Female
Spayed/Neutered
*
Yes
No
Current on Vaccinations?
*
Yes
No
Unsure
Name of veterinarian
*
Veterinarian address (street, city, state)
*
Veterinarian Phone Number (with area code)
*
Owner name on records at this vet
*
3) If there are other pets in the household, please use the space below to provide the same information for those pets.
*
2) Other pet in the House (Name, Breed, Age)
*
Gender
*
Male
Female
Spayed/Neutered?
*
Yes
No
Current on vaccinations?
*
Yes
No
Unsure
Name of veterinarian
*
Veterinarian address (street, city, state)
*
Veterinarian Phone Number (with area code)
*
Owner name on records at this vet
*
Is there any additional information about your current pets that you would like us to know?
*
Other previous pets?
If you previously have had other animals/pets, please complete the following:
1) Pet Name
*
Breed
*
Spayed/Neutered
*
Yes
No
Years owned
*
Where is this pet now?
*
Name of veterinarian for this pet
*
Location of this vet (city, state)
*
Veterinarian Phone Number
*
Owner name on records at this vet
*
If your current vet has seen your pet for less than 1 year, please provide the name & number of your previous vet below.Untitled
*
Is there any additional information about your prior pets that you would like us to know?
*
Has anyone in your household EVER given a pet away?
*
Yes
No
2) Pet Name
*
Breed
*
Spayed/Neutered
*
Yes
No
Years Owned
*
Where is this pet now?
*
Name of veterinarian for this pet
*
Location of this vet (city, state)
*
Veterinarian Phone Number
*
Owner name on records at this vet
*
If your current vet has seen your pet for less than 1 year, please provide the name & number of your previous vet below.Untitled
*
Has anyone in your household EVER released a pet to an animal shelter or rescue?
*
Yes
No
Has anyone in your household EVER sold a pet?
*
Yes
No
If YES to any of the last 3 questions, what were the circumstances?
*
Lifestyle Information
What temperament and activity level are you seeking in a foster dog?
*
Athletic/High Energy
Affectionate
Mellow
Quiet
Lap Dog
Are you fostering a dog for any of the following reasons?
*
Hunting dog
Guard Dog/Protect Property
What do you hope a foster dog/puppy will add to your life?
*
Do you own or rent?
*
Rent
Own
If renting, please provide your LANDLORD'S NAME and contact phone number:
*
How many hours each day will the foster dog or puppy be left alone?
*
Where will the foster puppy/dog be kept when alone? (select all that apply)
*
Indoors
Outdoors
In a dog crate
If indoors and not crated, in what room with the foster dog/puppy be kept?
*
What type of housing do you live in (single family house, apartment, townhouse, etc.)
*
Do you have a completely fenced yard?
*
Yes - electric fence
Yes- material fence
No
If FENCED, what is the height and type of fence?
*
Is there a gate?
*
Yes
No
Do you have a pool?
*
Yes
No
Is there a fence around the pool?
*
Yes
No
Where will the foster dog/puppy be kept during the day when you are home?
*
What type of exercise will you give the dog/puppy?
*
Realistically, how many hours per day do you have to exercise with and/or play with your foster dog?
*
Less than 1 hour
1-2 hours
2-3 hours
More than 3 hours a day
Where will the foster dog/puppy sleep at night?
*
How often will the foster dog/puppy get exercise?
*
Are there times when the foster dog will be tied outside?
*
Yes
No
If YES, when and for how long on average?
*
Training and development
What methods will you use to train your foster dog/puppy?
*
Do you know what causes heartworms?
*
Yes
No
Unsure
Do you agree to keep your foster dog/puppy on heartworm preventative all year round?
*
Yes
No
If your foster dog/puppy has an accident in the house, how will you correct him/her?
*
How long do you think housebreaking will take?
*
Have you previously applied to adopt a dog, puppy, cat or kitten from a rescue group or shelter?
*
Yes
No
If yes, when and what rescue group or shelter?
*
What was the result of the application?
*
Are you willing to have a MomsVA representative visit where the dog/puppy will be living?
*
Yes
No
Unsure
References
Please provide TWO personal references of someone not living in your home.
1) REFERENCE Name
*
1) Reference Phone Number
*
1) Relationship to you
*
2) REFERENCE Name
*
2) Reference Phone Number
*
2) Relationship to you
*
Is there anything else that you feel we should know?
*
AUTHORIZATION/RELEASE
Printing your name represents your official signature in the space(s) below.
By signing (spelling out your full name on this form) below and submitting this form, I certify that all information given in this form is true and correct, to the best of my/our knowledge. By submitting this form, I hereby further grant consent to MOMSVA (Making of Miracle Stories Animal Rescue of VA) and its agents to seek information about me from all named and unnamed sources within this form, including but not limited to veterinarians, rental agents, and personal references, regarding this application. Providing false information or refusing to sign below will result in the rejection of the request or the nullification of any adoption agreement. Signature/Name of Applicant
*
Signature/Name of second applicant if applicable
*
MOMSVA (Making of Miracle Stories Animal Rescue of VA)
reserves the right to approve or deny any application to foster for any reason and the right not to disclose that reason.
Upon clicking SUBMIT, your application will be sent to momsrescue@gmail.com for review.
Submit
