Shorewood Cocker Rescue, Inc. Foster Application


Name:

Address:

City:

State:

Zip Code:

Telephone: (Home) (Work) (Cell)

Email:

How did you hear about us?

List members of your household including yourself.

Name: Age:
Name: Age:
Name: Age:
Name: Age:
Name: Age:
Name: Age:

Do you have children who do not live with you visit your home? If so, how frequently and what age range are they?

Do you rent or own?
Rent
Own

If you rent, do you have your landlord's permission?
Yes
No

Do you have a fenced in yard?
Yes
No

What type of fence? How high?

If no, how will your cocker be exercised?

Are you willing to provide some training that might be needed? (house training, walking on a leash, non begging behavior)
Yes
No

Are all members of your family willing to accept your desire to become a foster parent?
Yes
No

What made you consider becoming a foster cocker parent?

Have you ever had a cocker spaniel before?
Yes
No

If yes, please tell me all of its good and bad points.

If no, are you aware of the grooming requirements and common health problems?
Yes
No

Are you willing to foster a dog with a special condition such as:
Blindness or vision impairment? Yes No
Epilepsy? YesNo
Hypothyroid? Yes No
Submissive wetting? Yes No

What other pets have you owned (pleasegive breed if dog, gender, and age)? Include all species.

Do youown them currently or where are they now?

If deceased what was the cause of death?

Are the other animals you currently ownspayed or neutered?
Yes
No

What qualities are you looking for in a foster dog?

What kind of behaviors do you feel you would be unable to tolerate in a foster?

If your cocker will be home alone during the day, how many hours per day?

Do you use a dog walker or day care service?

Where will the foster dog be during the day, night, or when you are on vacation?

Will you allow the dog on your furniture?

Do you agree to a pre-placement home visit and/or follow-up visits?
Yes
No

Do you know how to or are you willing to crate train a cocker?
Yes
No

Provide the following names and numbers (Please note that your application cannot be processed without reference checks):
1) Current or Previous Veterinarian:

Phone number:

Last name records are listed under:

Name of pet(s) and years owned:

2) Current or Previous Groomer:

Phone number:

Last name records are listed under:

Name of pet(s) and years owned:

3) Personal Reference (not a family member):

Daytime phone number:

Evening phone number:

4) If no Vet or Groomer, List a 2nd Personal Reference (not a family member):

Daytime Phone number:

Evening Phone number:

Date Applied:

Additional comments and/or questions:

ALL OF THE INFORMATION I HAVE PROVIDED ON THIS APPLICATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND COMPLETE.

Your application will be processed.

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