First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Please list your full name (First, last, middle initial) *

What is your birthdate?*

Best time to reach you?

Please list the names, ages and relation of all adults in the household

Please list the names, ages and relation of all children in the household.

Do you own or rent?

What is your landlord's name and telephone number?

What type of housing do you live in? (Apt/Condo, Townhouse, Single Family)*

How long have you resided at this address?

Do you have a fenced yard? E-fences are not permitted. Briefly describe it.*

How will you exercise the dog?

Have you ever owned a dog before? If so, what breeds?

What kind of experience have you had/have with dogs? (dog training, vet tech, groomer,agility, pet owner, etc)

Have you ever fostered an animal before? What was your experience?

If yes above, which rescue group did you foster for?

Please list ALL pets living in the home and if they are yours or belong to someone else. Are they spayed/neutered? With regard to your pets, how long have you had them?

Please provide the name and telephone number for the vet clinic that cares for your pets. We require a 2 year history of regular vetting.*

Have you had pets in the past? When? Briefly describe what happened to them:*

How many hours per day will the dog be left alone?*

Where will the dog stay during the day? During the night?

Who will be the primary caretaker for the dog?

Does anyone in the home have allergies?

If there are no children living with you, are there children that visit, for example, grandchildren, children you babysit, etc?

How often do you travel? Are you planning a vacation in the near future?

Have you ever crate trained a dog?

Are you willing to have someone from Saving Shepherds, MN visit your home for a home visit?

Are you willing to cover the costs of caring for a foster dog except for medical expenses?

Please supply names and telephone numbers for 3 personal references. Two must be non-related.*

By hitting "submit" below, I agree to release and hold harmless Saving Shepherds of MN, its board members, representatives, volunteers, and assignees from any damage whatsoever, including but not limited to personal injury and property damage, that may be sustained as a result of meeting or adopting a dog through Saving Shepherds of MN. I understand that interacting with dogs is not risk-free and I assume the risk of any physical injury, emotional distress, or property damage that may arise out of any such interaction. Please type, "I agree" below if you agree to these terms. *