Name
              
                * 
              
             
          
                
                
                  
                     
                    First Name 
                   
                
                
                  
                     
                    Last Name 
                   
                
               
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Co-applicant Name 
              
             
          
                
                
                  
                     
                    First Name 
                   
                
                
                  
                     
                    Last Name 
                   
                
               
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Address
              
                * 
              
             
          
                
                
                  
                     
                    Address 1 
                   
                
                
                  
                     
                    Address 2 
                   
                
                
                  
                     
                    City 
                   
                
                
                  
                     
                    State/Province 
                   
                
                
                  
                     
                    Zip/Postal Code 
                   
                
                
                  
                     
                    Country 
                   
                
               
            
            
            
        
          
          
            
            
            
            
            
              
                
            
              Email
              
                * 
              
             
          
                
                 
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              Occupation
              
                * 
              
             
          
                
                 
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Home Phone
              
             
          
                
                
                
                  
                     
                    (###) 
                   
                
                
                  
                     
                    ### 
                   
                
                
                  
                     
                    #### 
                   
                
               
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Work Phone 
              
             
          
                
                
                
                  
                     
                    (###) 
                   
                
                
                  
                     
                    ### 
                   
                
                
                  
                     
                    #### 
                   
                
               
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Cell Phone
              
                * 
              
             
          
                
                
                
                  
                     
                    (###) 
                   
                
                
                  
                     
                    ### 
                   
                
                
                  
                     
                    #### 
                   
                
               
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Emergency Contact Name
              
                * 
              
             
          
                
                
                  
                     
                    First Name 
                   
                
                
                  
                     
                    Last Name 
                   
                
               
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Emergency Contact Phone
              
                * 
              
             
          
                
                
                
                  
                     
                    (###) 
                   
                
                
                  
                     
                    ### 
                   
                
                
                  
                     
                    #### 
                   
                
               
            
            
        
          
          
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              Is there a specific dog you'd like to foster?
              
             
          
                
                 
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              If yes, and that dog is no longer available, would you be willing to foster a different dog in need?
              
             
          
                
                 
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              If approved, how soon are you able to take a foster dog?
              
                * 
              
             
          
                
                 
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Desired Age
              
                * 
              
             
          
                
                
                
                  
                    Puppy 
                  
                    Teen 
                  
                    Middle Aged 
                  
                    Senior 
                  
                    Any of the Above 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Desired Sex
              
                * 
              
             
          
                
                
                
                  
                    Male 
                  
                    Female 
                  
                    Non-Conforming 
                  
                    Who Cares? 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Desired Size
              
                * 
              
             
          
                
                
                
                  
                    Small 
                  
                    Medium 
                  
                    Large 
                  
                    Any Size 
                  
                     
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Desired Activity Level
              
                * 
              
             
          
                
                
                
                  
                    High Energy 
                  
                    Medium Energy 
                  
                    Low Energy 
                  
                    Any of the Above 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are you ok with temperament tested Bully or Bully Mix Breeds (Pitt Bull, Boxer, Mastiff, Bull Dog, etc)?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    Yes and I have bully breed experience 
                  
                    No 
                  
                     
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are you willing to foster a special needs dog?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                    Depends on the disability 
                  
                    I want the three legged blind dog NOW! 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Please list the ages of all humans in your home.
              
                * 
              
             
          
                
                
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Does anyone in your family/household have allergies?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              If so, how do you combat them?
              
             
          
                
                
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              May we visit your home prior to application approval?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                     
                  
                     
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Please list all of the past and present pets in your household (please include species/age/sex/approx weight/spayed/neutered):
              
             
          
                
                
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              What vet clinic do your pets see?
              
             
          
                
                 
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are your pets up to date on vaccines/flea and heartworm prevention?
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                    Unsure 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              How long have you been at your current address?
              
             
          
                
                
                
                  
                    Less than a year 
                  
                    1-5 years 
                  
                    5-10 years 
                  
                    10+ years 
                  
                     
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Do you own or rent?
              
                * 
              
             
          
                
                
                
                  
                    Own 
                  
                    Rent 
                  
                     
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              If you rent, please provide your landlord's name and number.
              
             
          
                
                
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Does your landlord have a size restriction for dogs?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                    What dog? 
                  
                    N/A 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              How long daily will the dog be left alone without humans?
              
                * 
              
             
          
                
                
                
                  
                    He's never leaving my sight! 
                  
                    A few hours on occasion 
                  
                    During regular working hours 9-5 
                  
                    Random schedule and hours 
                  
                    If he's not with me he will always be with a relative or caretaker 
                  
                     
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Where will the dog stay when you're away from home?
              
                * 
              
             
          
                
                
                
                  
                    What's a vacation? 
                  
                    What's a vacation without my best friend? 
                  
                    We have plenty of friends/relatives to cover 
                  
                    Board at a veterinarian or animal daycare center 
                  
                     
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are you familiar with crate training during your absence and/or at night?
              
                * 
              
             
          
                
                
                
                  
                    Champion Crate Trainer Extraordinaire! 
                  
                    Kinda, but may need some pointers. 
                  
                    You mean like a milk crate? 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are you familiar with heartworms and/or heartworm treatment?
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                    Somewhat 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Do you have a yard?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                    Tiny, but does the job 
                  
                    In the front and the back, not to brag 
                  
                    A yard? My property is the size of the French Quarter 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              If yes, does it have a secure fence?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                    Fence, yes. Secure, questionable. 
                  
                    Alcatraz Schmalcatraz 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Will the dog be walked daily and/or be allowed to exercise?
              
                * 
              
             
          
                
                
                
                  
                    Yes, I am very active and I plan to include the dog 
                  
                    Yes, I'll play fetch with him from the recliner 
                  
                    I am hoping for a low energy dog that doesn't need walking 
                  
                     
                  
                     
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Please tell us a little about your family's lifestyle including any special activities in which your foster dog would be included.
              
             
          
                
                
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are you prepared to keep your foster dog leashed at all times when not in a secured yard?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are you aware of the state and local leash laws?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    There are laws about leashes? Tell me more! 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Have you or any member of your family/household ever been cited for leash law violations or cruelty to animals in the past? If yes, please explain.
              
                * 
              
             
          
                
                
                
                  
                    Never 
                  
                    Yes, but I can explain 
                  
                    Yes and I have no excuse. 
                  
                     
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Fosters can take up to 6 months to find homes for. Are you willing and able to care for an animal for this length of time? If not, would you allow us a minimum of 2 weeks to find a replacement foster home? Do you have reliable transportation to bring your foster dog to and from vet appointments in the Greater New Orleans area? All scheduled services will be billed to our account and you won't be responsible for any out of pocket vetting costs. Monthly flea and Heartworm prevention is provided as well for the duration of your foster time.
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are you willing and able to bring your foster dog to our adoption events in the Greater New Orleans area?
              
             
          
                
                
                
                  
                    Yes 
                  
                    Depends 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Do you own a vehicle you can transport your foster dog in?
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              In the event that you would like to adopt your foster dog, you must notify us in writing of your wishes. The standard application process and adoption fee will still apply. You may not adopt your foster dog if he/she has a scheduled meet and greet, home trial visit or an adoption planned. We do not list our rescue dogs publicly for adoption until they are fully vetted, so there will be time to let us know you'd like to apply for him/her. Do you agree to these terms?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              We like to include our foster parents in scheduled meet and greets with approved applicants. We may ask you to reach out to an approved potential adopter to better plan a meet and greet around your schedule. We strongly welcome, encourage consider our foster family's input on the fit of the potential adopter, but ultimately the final decision belongs to our adoption team. Do you agree to these terms?
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Please tell us how you found us.
              
                * 
              
             
          
                
                
                
                  
                    Google Search 
                  
                    Friend/Family Referral 
                  
                    Petfinder 
                  
                    Media or Publication 
                  
                    Other 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              I/we attest that we have retained a copy of the terms of the terms and conditions of fostering and also understand that completion and submission of this application does not guarantee the fostering of a dog from Trampled Rose Rescue & Rehab.
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              I/we attest to the information provided on this application is true and accurate to the best of my/our knowledge.
              
                * 
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
                 
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              I/we attest that the terms and conditions of our foster program as stated above have been fully read and understand that this is part of the fostering process, should be taken seriously and will be enforced. I/we attest to the information provided on this application is true and accurate to the best of my/our knowledge. I/we attest that we have retained a copy of the terms of the terms and conditions of fostering and also understand that completion and submission of this application does not guarantee the fostering of a dog from Trampled Rose Rescue & Rehab. Please select Yes if you agree ad No if you do not.
              
             
          
                
                
                
                  
                    Yes 
                  
                    No