S©P©C©A of Northern Virginia
DOG FOSTER HOME APPLICATION

Thank you for volunteering to be a foster parent. Please answer the following questions before deciding to foster. We want to ensure the best possible match between foster parents and dog. The SPCA will cover all medical costs while the dog is in foster care. Keep in mind the following points.

If you have any trouble with submitting this form, please email the information requested to dog_foster@spcanova.org.

Name: Home Phone:
Spouse/Other Adult Name: Relationship:
Address: Work Phone:
Cell Phone:
City:State: ZIP: E-Mail:
Employer: Occupation:
Spouse/Other Adult Employer: Occupation:

Type of Residence:Single-family Home Apt Condo Townhome
Does it have a completely fenced yard? Yes No     If Yes, type (chain link, etc.) and height:
Do you rent own  How long have you lived at present address?:
If renting, does your lease allows pets? Yes No   Not Applicable               Weight Limit:
Management Company or Landlord and phone number :
Do you anticipate a transfer out of the area? Yes No. If yes, when?
Do you travel or relocate frequently? Yes No   If Yes, please elaborate:
List all members of household (including live-in help) and ages of all children:
(We are careful about placement of some dogs  in homes with small children)
Does any member of your household have allergies to animals? Yes No
Is someone home during the day? Yes No.
If Yes, who?  During what hours?
If no one is home most of the day, about how many hours will the dog be left alone?
Who will be the dog's primary caregiver?
Who will exercise the dog, and how?
Where will the dog be kept while you are home?
Where will the dog be kept while you are away (at work, shopping, etc.)
If confined in a room, which room?
If crated, where will the crate be kept?
Where will the dog sleep (bedroom, kitchen, etc.)?
What will you do with the dog when you are out of town?
Do you have a doghouse or outside pen/kennel?

List all current and previous dogs/cats that you personally have been responsible for, with species, sex, spay/neuter status and where each is now:

How many animals do you currently have in your home?
Are they spayed/neutered Yes No  Are all current on vaccinations?  Yes No
If you have cats, are they indoors or outdoors? Tested negative for feline leukemia Yes No.
Do you have a veterinarian? Yes No  Not Applicable
If Yes, Name & Phone Number
Personal reference not related to you, with relationship, address and phone number:
Second personal reference (if no vet reference):

Please tell us why you want to foster a dog:


Thank you for taking the time to reply. The Foster Home Coordinator will be in touch with you soon.