Foster Care Provider Application - Southern Cross Boston Terrier Rescue

Thank you for your interest in fostering a rescue dog through Southern Cross Boston Terrier Rescue. To be considered for fostering we ask that you FULLY complete the form below. PLEASE NOTE: Allow 15-30 minutes to complete this application, as your answers will not be saved if you leave the form before submitting. It can take up to two weeks to process your application, only approved applicants will be contacted. If you currently own pets you MUST list a vet reference, please contact your vet to give permission to release your pet's vet records to SCBTR prior to submitting this form. Thank you for choosing rescue.

Name *

First

Last

Email *

Street Address *

City, State ZIP *

Home Phone (enter N/A if none) *

Mobile Phone #

Please enter your drivers license # *

Please enter your date of birth (DOB): *

Please indicate the # of adults in the home *

How many of the adults in your home are men? *

How many of the adults in your home are women? *

How many children are in your home? *

Please give the ages and gender of all children in your home. Type 0 if none. *

Do you own or rent? *

Own
Rent

If you rent, do you have the owners permission to keep a dog?

How large is your yard? *

Is it securely fenced? *

If yes, what type of fence and how tall?

If you have a fence, does it have a gate?

Yes
No
I don't have a fence

If you have a fence with a gate, what type is the gate?

If you have a fence with a gate, can children open the gate?

If you have a dog run, is it secure?

Yes
No
I don't have a dog run

If you have a pool, pond, lake or other large body of water, is it securely fenced to prevent the dog from entering it? *

Yes
No
I do not have any large bodies of water

Are you aware of any dangers inside your yard that could harm the dog? *

If your yard is not fenced, how do you plan to insure that the dog receives safe and adequate exercise? *

Where will the dog(s) sleep? *

Do you plan to use a crate? *

Would you use a crate if necessary? *

Do you have an area where the dog can take refuge from the elements (i.e doghouse, kennel area, etc)? Please describe below: *

If you answered no to the above question, do you plan to acquire shelter prior to accepting your first rescue?

Have you ever owned a Boston Terrier before? *

If you answered "yes" to the above question, how long did you own this dog and what happened with this dog?

If you previously owned a Boston Terrier, where did you acquire the dog?

Do you own any other pets at this time? *

If you answered yes to the above question please specify the number of current pets, including the NAME, species, sex, spayed / neutered and age of each. If none, please type "none" *

If you currently have pets, are their vaccinations up to date? *

Yes
No
I currently do not have other pets

If you currently do not own pets, have you previously owned a dog or cat?

If you have other pets, what has been your main problems / concerns with them?

If you currently have other pets, how do you think they will react to a rescue dog?

If you have other dogs, have you ever seen them act aggressively towards other animals?s *

Yes
No
I have no other dogs

If you have another dog(s), would you consider your dog to be submissive to other dogs?

Yes
No
I am not sure

Are you prepared to deal with the reactions of your pets?

IF YOU CURRENTLY OWN PETS, YOU ARE REQUIRED TO HAVE A VETERINARIAN / CLINIC TO FOSTER. Do you have a veterinarian / clinic? Please enter the name, address and phone number of your veterinarian or clinic? *

IF YOU DO NOT CURRENTLY OWN PETS WITH A VET / CLINIC REFERENCE, please list three (3) references that we may contact including name, phone number and email address:

Are you willing to foster a Boston for a short period of time? *

Are you willing to foster a Boston for a longer period of time if not immediately adopted? *

Why do you want to foster a Boston Terrier? *

Please let us know what regional areas (city, state or, by state regions) that you would be willing to cover with regard to rescue: *

Would you be willing to take other dogs that don't meet the criteria above in emergency situations? *

Are you prepared to provide the extensive socialization that is needed to insure that you have a well rounded Boston for placement? *

What medical considerations will you make in taking a rescue dog? (e.g. won't take a dog diagnosed with heartworms, etc) *

Are you agreeable to having EVERY dog that you foster spayed or neutered? *

How many dogs are you willing to foster at the same time? *

Are you likely to provide dogs in your foster care with training? *

What is your definition of disciplining a dog? *

How will you deal with behavior problems in a rescue? (e.g. aggression, house soiling, etc.) *

Would you be able to handle a dog that comes into rescue only to become sick and have to be euthanized to stop its suffering? *

Are you agreeable to having dogs euthanized because of aggressive temperament problems? *

If you answered "no" to the above question, what would be your alternative solution?

Could you commit to the remainder of the dog's life should they not be adoptable, their placement not work out, or they need to come back to rescue ? *

How would you handle a situation where your rescue dog bit you? *

How would you handle a situation where your rescue dog bit someone else? *

Would you be willing to deny an adoptive family of a particular dog because the situation did not "feel" right? *

Would you be willing to allow us to visit your home? *

Do you have the support of your family in view of rescue? *

Are you willing to work closely with SCBTR in making a placement for the rescue dogs? *

Are you financially able to provide adequate food and medical care for the rescue? (Medical care is reimbursed to you) *

Have you emotionally prepared yourself for the sadness that comes when you finally make a placement? *

Are you willing to stay in contact with the adoptive home to ensure that the placement was a success, including follow up visits and/or phone calls? *

Are you willing to provide counseling / resources to the adoptive family should problems arise later on in the placement? *

I, the undersigned, attest that, to the best of my knowledge the above information is accurate and complete at the time of signing, and I understand that falsely provided information can mean that my application will be terminated. Please enter your name if you agree. *

Please enter today's date: *

Phone