AVGRR Foster Home Application
PERSONAL INFORMATION Date of Application ___________
Name of Applicant ______________________________________________________
City, State, Zip _________________________________________________________
Phone ________________________ e-mail _________________________________
Employer _______________________________City __________________________
Occupation _______________________ Typical # of Hours Worked ____________
Name of Co-Applicant (Adults over 18 yrs only) _____________________________
Relationship to Applicant: Spouse ___ Significant ____ Roommate____ Other ____
Employer: _______________________________ City _________________________
Occupation: ________________________Typical # of Hours Worked ____________
1. How did you hear about Autumn Valley Golden Retriever Rescue?
2. Why do you want to foster a Golden Retriever? __________________________
3. Humans in the household? Adult _________ Ages _________________
4. If there are children in the household (including visiting grandchildren), are
they experienced with pets/dog? ______________Yes ______________No
5. Who would have primary responsibility for caring for a foster dog? _________
6. Do you have any health problems, which might affect your fostering
7. Are you willing/able to adjust your schedule (if needed) while a foster dog
becomes acclimated to you home? ______ How? __________________________
8. Is there anyone home during the day? _______ Who? _____________________
If not, how long will the foster dog be left alone? __________ Where will he be
kept while alone? _______________________
9. Please describe your experience with dogs, including any formal obedience
training which you have participated.
10. Do you have any training in behavior training of modification?____________
If yes please describe? _______________________________________________
11. Do you own a large crate and are you familiar with the use of crates as it
relates to dog training? _______________________________________________
12. Describe any medical treatment you have given to dogs (i.e. shots, pills, or
other medication, etc.) _______________________________________________
13. Are you comfortable with _____bathing a dog _____ grooming a dog
_____housetraining _____clipping toenails _____giving oral or topical
medications ______shy dogs ________active dogs.
14. Have you ever had a pet/dog die at an early age, please give details ________
15. Are there any restrictions on how long you can foster a dog? ______________
16. Are you prepared to commit to fostering, knowing that a foster could possibly
stay in your household for several weeks/months? ______________________
17. When would you be able to start fostering? _____________________________
1. Do you live in a ___house ___townhouse ___apartment ____mobile home
2. Do you ______own __________rent.
3. If you rent, what is the landlords policy on pets/dogs? ____________________
4. Landlords Name ________________________Phone _______________________
5. Do you have a fenced yard? _________What type ______________________
Height of fence? ____________________________________________________
6. If you do not have adequate fencing (i.e. totally enclosed & secure) how will
you provide exercise for the dog? (potty exercise and physical exercise)?
7. Who will be the primary person responsible for exercising the foster dog?
8. Where will the foster dog spend its daytime? ___________________________
9. Where will the foster dog sleep at night? _______________________________
10. What dog food do you currently feed your dogs? _______________________
11. How many times per day do you feed your dogs? _______________________
12. What types of "dog supplies" do you currently have on hand? ____________
13. Do you have pets in your home now? _____Yes ______No
14. If yes, please list all pets, Sex, breed, ages, spayed/neutered
15. Do your pets live ____inside ___mostly inside ____ mostly outside ___outside
16. Are your dogs house trained? _____Yes _____No.
17. List ANY behavior problems your dogs have. ___________________________
18. Have your dogs ever bitten a human? __________Yes ____________No
19. If yes, please give full details _________________________________________
20. Have your dogs ever shown aggression towards other animals?
21. If yes, please give full details _________________________________________
22. Are all of your dogs/pets current on all vaccinations? _____Yes _____No
23. What types of Goldens are you willing to foster? ____Males ____Females
____Adults ____Puppies ____Dogs taken in from private owners
____Dogs taken in from shelters ____Abused/Neglected dogs
24. Any comments or concerns that you have concerning fostering?
Please list 2 references: Name/relationship/complete phone number:
Veterinarian that you use the most: Name and phone number
How long have you used this veterinarian? ________________________________
How many minutes drive from you house is this veterinarian? _______________
I acknowledge that the information contained in this form is true and correct to the best of my knowledge. I understand that any misrepresentation of fact, may result in the removal of the foster dog from my home.
Signature of Applicant __________________________________Date ____________
Signature of Co-Applicant _______________________________Date ____________
Give this application to any officer of the Autumn Valley Golden Retriever Rescue
Or mail to: Autumn Valley Golden Retriever Rescue, P.O. Box 779, Vestal, NY 13850