Name

Email Address

Address

City

State

Zip

Cross Streets

Home Phone

Cell Phone

Alternate Phone

Emergency Contact:
Name:

Phone #

Any preference in dogs you want to foster?
(ie: Age, Gender, Special Needs, etc)

How many dogs are you willing/able to foster at one time?

Have you had any foster experience?
YesNo

If yes, please describe, please include which groups and what type of animal fostered

Have you adopted animals before? YesNo
If yes, please give details

Have you had animals before?
YesNo

What kind?

What happened to them?

How many animals do you currently have?

Please list your current animals below:

Animal #1:
Kind
Breed
Age
Gender
Spayed/Neutered?
Vaccinated?
Next vaccines due date:

Animal #2
Kind
Breed
Age
Gender
Spayed/Neutered?
Vaccinated?
Next vaccines due date:

For additional animals please add the requested information below:

About your home and family:
We Rent:
HouseApartmentOther
If you rent does your landlord allow dogs? YesNo

Are there any breed restrictions?
YesNo

Any restrictions on the number of dogs you may have?

Please attach confirmation from landlord stating the number of dogs you are allowed

We Own:
HouseCondoOther

If you have a homeowner association do the regulations allow dogs?
YesNo

Are there any breed restrictions?
YesNo

Any restrictions on the number of dogs you may have?

Please attach confirmation from HO Assn stating the number of dogs you are allowed.

Does your residence have a dog door?
yesno

Is your yard fenced?
yesno

If so, what type of fence?
BlockWoodChain LinkOther

How tall is your fence?

Does your home have a pool?
yesno

If yes, will the foster dog(s) be blocked from pool access when unattended?
yesno

How many children live in your home?

List their ages

How many adults live in your home?

Is anyone in your home allergic to dogs?
yesno

How often do children visit your home?

How many hours per day would your foster dog(s) be unattended while your family
is at work or school?
Please give details:

Where will foster dog(s) be kept during the day while you are away?
InsideOutsideOther

Where will foster dog(s) be kept during the night?
InsideOutsideOther

Our family's activity level is:
Very active and always on the goModerately active, at home a few nights per weekNot very active, at home 5-7 nights per weekSomeone is always home

Do you have reliable transportation?
yesno

Arizona Chihuahua Rescue uses social media to promote our dogs. Please check the social media sites you use:
FacebookInstagramTikTokSnapchatTwitter

The applicant agrees to be the primary caregiver, and any/all foster dog(s) will be cared for at the home address listed above. If for any reason that arrangement needs to change, prior approval is required.

Liability Release and Waiver: I, the undersigned, understand that my participation with the Arizona Chihuahua Rescue is strictly on a volunteer basis. I understand that there are inherent risks associated with my volunteer activities, including the risk of personal injury resulting from animal bites and other animal behavior. In exchange for the Arizona Chihuahua Rescue agreement to allow me to participate in its volunteer program, I hereby release the Arizona Chihuahua Rescue, including its officers, agents and members, from any and all claims of liability of any kind whatsoever, including but not limited to claims negligence and/or injury to me arising out of my participation in the Arizona Chihuahua Rescue volunteer program. I understand that by signing below, I am waiving any and all claims against the Arizona Chihuahua Rescue, its officers, agents and employees of any kind whatsoever arising from the taking of custody of the animal by the Arizona Chihuahua Rescue, including but not limited to claims of negligence, veterinary malpractice, conversion, breach of contract and/or personal injury, or any damages to volunteers vehicles or property on or in said vehicle. Volunteers must carry their own Automobile Insurance. Arizona Chihuahua Rescue is not responsible for any damages to volunteers vehicles or property on or in said vehicle.

Please sign below:

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