Being a voice for the voiceless

• Foster Application

• Full Name*
  First NameLast Name
• Age
• E-mail*
• Address*
  Street Address

  Street Address Line 2

  CityState / Province

  Postal / Zip Code Please Select Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country
• Phone Number - Cellular
  -Area CodePhone Number
• Phone Number - Work
  -Area CodePhone Number
• Do you live in a:*
  Please Select House Townhouse Condo Apartment Duplex Other
• Do you:*
  OwnRentLive with ParentsOther
• If Renting: Please indicate landlord contact information
• Household Setting
  RuralCity
• Describe the Activity Level in your Home
  Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests
• Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*
• Does Anyone in your Household have Allergies to Animals?
  YesNo
• Are all members of your Family agreeable to Fostering a Dog?
  YesNo
• Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm, Living/Deceased)
• Veterinarian Name
  First NameLast Name
• Address
  Street Address

  Street Address Line 2

  CityState / Province

  Postal / Zip Code Please Select Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country
• Phone Number
  -Area CodePhone Number
• Do you have a preference in the sex of foster?
  MaleFemaleNo Preference
• What size dog are you willing to foster? (Check all that apply)*
  SmallMediumLarge
• Are you willing to foster a dog of any age?
  YesNo
• If not, what age would you consider?
• Please describe the type of dog you are willing to foster (Please include breed, coat length, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes*
• Are you willing to take your foster dog to vet appointments at a convenient time for you?
  YesNo
• If No please explain
• Are you willing and able to medicate your foster, even if it is just a monthly heartworm preventative?
  YesNo
• We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?
  YesNo
• Have you had any experience with an emotionally or physically neglected or abused dog?
  YesNo
• If Yes please explain
• Are you willing to use a crate for a dog if recommended?
  YesNo
• Do you have a fenced yard?
  YesNoPartial
• If fenced, please give details on height, material, # of gates, are gates locked or lockable?
• How many hours in a day would the foster be left alone?*
• What are you plans to exercise your foster? Please list any parks near by or trails, how many walks a day, approximate length, activities such as agility*

• By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

  I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Riley's Pet Rescue animal fostered by me.

  I certify that the above information is correct, and I understand that the information will be verified.

  I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Riley's Pet Rescue and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog.

  I accept full responsibility for the dog(s) actions at all times, and release Riley's Pet Rescue from any liabilities or damages that may be incurred because of fostering such dog(s).

  I agree to have Riley's Pet Rescue complete reference call checks and conduct a home visit inspection to be able to approve my foster application.

  I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to Riley's Pet Rescue.

• Click to edit
  -Month -DayYearDate Picker Icon 1 2 3 4 5 6 7 8 9 10 11 12 :Hour 00 10 20 30 40 50 Minutes AM PM AM/PM Option
• Your name*
• Co-Applicant name (if applicable)
• Phone Number of Co-Applicant
  -Area CodePhone Number
• Full Name
  First NameLast Name
• Should be Empty: