ESRA FOSTER HOME APPLICATION FORM

Your electronically submitted form will be used to expedite the approval process; however,
final approval will be pending receipt of your ORIGINAL SIGNED COPY of this form and the ESRA Code of Ethics.

Complete this form. Be sure to scroll all the way down until you see “Click to Continue”.
On the following page please PRINT a hard copy to send to ESRA.

Very Important Hint: Use the "Tab" key or your mouse to move the cursor to the next field to fill out.
Hitting the "Enter" key will cause the form to be submitted immediately, even if it is not completely filled out.
 
Full name
Email address
Phone
Alt. Phone   This is:   work   cell   other
Street Address No P.O. boxes, please!
City State Zip Code

 

If approved, I will be fostering for ESRA as:
an active rescue member of ESRA. (Membership Application must also be submitted)
a temporary foster home for a dog with the intent to adopt that dog for my own.

Breeds you've had experience with:

Describe what types of experience you've had with dogs and for how long:

Ever attended obedience classes? Describe:

Experience with other animals:

Dogs now in your household (breed, gender, age, altered?):

Other pets in household:

Children in household (name, gender, age):

Any medical or allergy conditions in family members:

How many and what gender dog(s) can you foster at one time?

Length of time you are willing to foster:

Fenced yard? (please describe):

Crate/s (type & size available):

Kennel run (please describe):

Amount of time per day dog will be alone, and where:

Please list your vet and one other person knowledgeable about your care of dogs (trainer, groomer, breeder, etc.):
1. Vet's Name
Business Name
Email (if known)
Phone
Address
City    State
   
2. Reference Name
Relationship/Credentials
Email (if known)
Phone
Address
City    State
   

Your questions/comments:

 
 
 
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