Foster

*Name:

*Occupation:

Spouse's Name (If Applicable):

*Email Address:

*Home Phone:

Work Phone:

Cell Phone:

*What is the best time for us to contact you? *What is the best time for us to contact you?MorningMid-DayAfternoonEveningAny TimeOther

Please provide more information on the best time to get in touch with you:

*Street Address:

*City:

*Province:

*Postal Code:

*Home Type: *Home Type:ApartmentHouseCondoOther

*Do you rent or own your home? *Do you rent or own your home? Own Rent

Please note: renters must provide additional documentation from their landlord which specifics that dogs are allowed in the dwelling. Documentation can be emailed to btprmb@gmail.com. Please note: renters must provide additional documentation from their landlord which specifics that dogs are allowed in the dwelling. Documentation can be emailed to btprmb@gmail.com.

A fenced-in yard is required to be approved as a foster parent. Please select how the dog will access the yard for exercise and elimination: A fenced-in yard is required to be approved as a foster parent. Please select how the dog will access the yard for exercise and elimination: Doggie Door Totally Fenced-In Yard Partially Fenced In-Yard or Area Future Plans for Fenced-In Yard or Area Other (Please Describe)

Please provide more information as to how the dog will access exercise and elimination:

What Type of Fence Do You Have? What Type of Fence Do You Have? Wood Plastic Chain Link or Metal Other (Please Describe)

Please provide more details about the type of fence you have:

What is the height of your fence? What is the height of your fence? 4 Foot 5 Foot 6 Foot Other (Please Describe)

Please provide more details about the height of your fence:

Does your fence have any holes or gaps in it? Does your fence have any holes or gaps in it? Yes No

Please provide details and describe the gaps or holes in your fence, including location and size:

Foster parents living in a dog-friendly apartment or condo will be expected to abide by local leash laws at all times. Please select how the dog will access the yard for exercise and elimination: Foster parents living in a dog-friendly apartment or condo will be expected to abide by local leash laws at all times. Please select how the dog will access the yard for exercise and elimination: Outdoor fenced pet relief area Leashed outdoor visits, walks, or park Indoor litter box/elimination area Other (Please Describe)

Please provide more information as to how the dog will access exercise and elimination:

Please provide more details about your type of home:

*Does the primary animal caregiver work: *Does the primary animal caregiver work: Full-Time Part-Time Retired or Not Currently Working Other

Please provide more information about the work schedule of the primary animal caregiver:

Do you work from home? Do you work from home? Yes No Sometimes

Please specify how many hours the primary animal caregiver works from home in a week:

*Will there be any provisions made if you are away during your foster care time? Please provide additional details:

*On average, how long will this dog be left alone each day?

*Where will the dog be kept while at work? *Where will the dog be kept while at work? Kennel or CrateDog BedSpecific Area or RoomRun of the HouseOther

Please provide additional information on where the dog will be kept while you are away at work:

*Where will the dog be kept at bedtime? *Where will the dog be kept at bedtime?Kennel or CrateDog BedSpecific Area or RoomRun of the HouseOther

Please provide additional information on where the dog will be kept at bedtime:

*Where will the dog be kept while no one is home? *Where will the dog be kept while no one is home?Kennel or CrateDog BedSpecific Area or RoomRun of the HouseOther

Please provide additional information on where the dog will be kept when no one is home:

*Where will the dog be kept while on vacation?

*Do you have any children at home? *Do you have any children at home?YesNo

Have your children been around pets? Have your children been around pets? Yes No

Would your children be participating in the care of the animal fostered? Would your children be participating in the care of the animal fostered? Yes No

*Please list ALL members in your household including yourself: *Please list ALL members in your household including yourself:

Name

Age and Relation

Name

Age and Relation

Name

Age and Relation

Name

Age and Relation

Name

Age and Relation

Name

Age and Relation

Name

Age and Relation

Please list ALL pets that currently live in your household: Please list ALL pets that currently live in your household:

PET #1 PET #1

Pet Type

Breed

Gender

Age

Spay or Neuter? Spay or Neuter?YesNo

Please explain why:

PET #2 PET #2

Pet Type

Breed

Gender

Age

Spay or Neuter? Spay or Neuter?YesNo

Please explain why:

PET #3 PET #3

Pet Type

Breed

Gender

Age

Spay or Neuter? Spay or Neuter?YesNo

Please explain why:

PET #4 PET #4

Pet Type

Breed

Gender

Age

Spay or Neuter? Spay or Neuter?YesNo

Please explain why:

*If you are a dog owner, is your dog vaccinated against Bordetella (kennel cough)? *If you are a dog owner, is your dog vaccinated against Bordetella (kennel cough)? Yes No Not Applicable

Boston Terrier and Pug Rescue of Southern Manitoba vaccinate all its foster dogs against bordetella and encourages all potential foster parents to vaccinate their own dogs. The primary veterinarian has agreed to offer this vaccination at a reduced cost to participating foster families. If a foster family chooses not to vaccinate their own dog against bordetella, BTPRSM cannot be held liable for medical costs associated with an outbreak of bordetella in the home for owned dogs. Boston Terrier and Pug Rescue of Southern Manitoba vaccinate all its foster dogs against bordetella and encourages all potential foster parents to vaccinate their own dogs. The primary veterinarian has agreed to offer this vaccination at a reduced cost to participating foster families. If a foster family chooses not to vaccinate their own dog against bordetella, BTPRSM cannot be held liable for medical costs associated with an outbreak of bordetella in the home for owned dogs.

*Are your current dogs licensed with the City of Winnipeg or the town/community in which you reside? *Are your current dogs licensed with the City of Winnipeg or the town/community in which you reside? Yes No Not Applicable

*Have you ever lost a pet, had it die at an early age, or had it die due to an accident? *Have you ever lost a pet, had it die at an early age, or had it die due to an accident? Yes No

Please provide details

Do you have any experience in training (housebreaking, basic commands, etc)? Do you have any experience in training (housebreaking, basic commands, etc)? Yes No

Please briefly describe your training experience

Are you willing to provide basic training for the fostered animal? Are you willing to provide basic training for the fostered animal? Yes No

Do you have a preference on the gender of foster dog you would like to be placed with? Do you have a preference on the gender of foster dog you would like to be placed with? Male Female No Preference

Do you have a preference on the breed of foster dog you would like to be placed with? Do you have a preference on the breed of foster dog you would like to be placed with? Boston Terrier Pug Mix No Preference

The majority of dogs who come into the rescue will need work on their housebreaking skills. Some will need to be entirely housebroken, especially those who came from living outdoors, or from a backyard breeder or puppymill. Even dogs that have previously been housebroken can still have the occasional accident while the dog adjusts to its new surroundings and routine. The majority of dogs who come into the rescue will need work on their housebreaking skills. Some will need to be entirely housebroken, especially those who came from living outdoors, or from a backyard breeder or puppymill. Even dogs that have previously been housebroken can still have the occasional accident while the dog adjusts to its new surroundings and routine.

Would you be willing to work with a dog that was not fully housebroken? Would you be willing to work with a dog that was not fully housebroken? Yes No

Would you be willing to foster a dog with special medical needs? Would you be willing to foster a dog with special medical needs? Yes No

Would you be willing to foster a dog with some behavioural problems? Would you be willing to foster a dog with some behavioural problems? Yes No

Do you have any time constraints on the amount of time the animal can remain in your home? Do you have any time constraints on the amount of time the animal can remain in your home? Yes No

Please provide additional information about the time constraints that you have

Please provide the name and contact information for your current veterinarian: Please provide the name and contact information for your current veterinarian:

Vet Clinic Name

Name of Veterinarian

Vet Clinic Address

Vet Clinic Phone Number

May we contact your vet for an animal care reference? May we contact your vet for an animal care reference? Yes No

Please list two other references that we may contact regarding this application request: Please list two other references that we may contact regarding this application request:

REFERENCE #1 REFERENCE #1

Name of Reference

Phone Number

Relation

REFERENCE #2 REFERENCE #2

Name of Reference

Phone Number

Relation

Additional Comments:

All dogs placed in foster care remain the property of the Boston Terrier and Pug Rescue of Southern Manitoba. Under no circumstances may the dog be removed from the foster home by anyone other than the Boston Terrier and Pug Rescue of Southern Manitoba. The dog must be returned to the Boston Terrier and Pug Rescue of Southern Manitoba if requested. All dogs placed in foster care remain the property of the Boston Terrier and Pug Rescue of Southern Manitoba. Under no circumstances may the dog be removed from the foster home by anyone other than the Boston Terrier and Pug Rescue of Southern Manitoba. The dog must be returned to the Boston Terrier and Pug Rescue of Southern Manitoba if requested.