SPCA of Northern Virginia: Foster Home Application

spcalogo.gif (3180 bytes) DOG FOSTER HOME APPLICATION

Thank you for applying to be a foster parent for the SPCA of Northern Virginia. We want to ensure the best possible match between foster parents and their foster dog.
If you haven't already, please review the Dog Foster Responsibilities.

Keep in mind the following points:

In case of medical problems, please notify an SPCA member who has medical authorization to schedule a vet appt.
The foster parent is responsible for bringing the dog to our adoption fairs.
Foster parents also provide food, toys, and lots of love!
Dogs will not be placed in foster homes with unneutered pets.

Please review the foster dog responsibilities.

Contact Information

Name:

Address:

City:

State:

ZIP:

E-Mail:

Home Phone:

Work Phone:

Cell Phone:

Employer:

Occupation:

Spouse/Other Adult Name:

Relationship:

Occupation:

Spouse/Other Adult Employer:

Your Home Environment

Type of Residence: Single-family HomeApt 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:

Your Pets

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):

If you are interested in fostering a particular dog, which one?:

Please tell us why you want to foster a dog:

Thank you for taking the time to reply. Our Volunteer Coordinator will be in touch with you soon.

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

Your Home Environment
Type of Residence:	Single-family HomeApt 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:

Your Pets
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):
If you are interested in fostering a particular dog, which one?:
Please tell us why you want to foster a dog:
*Thank you for taking the time to reply. Our Volunteer Coordinator will be in touch with you soon.*