Burttschell Rescue Ranch Foster Application

Help Burttschell save more animals by providing a temporary home to a pet in need so we can take in more animals and save more lives.

For any questions that don't apply to you put NA.

Name:
Date
Home & Work phone:
Best time to call?
Address Address
Street Address City State / Province / Region Postal / Zip Code
Email:
Housing Status:

Housing Status: Own Rent My housing status is, please describe: My housing status is, please describe:
If you rent, does your lease allow pets?
Landlord's name & phone number:
Please describe any restrictions on the number or type of animals that you are allowed to
house:
Name and relationship of other adults in your household:
Name and ages of children in your household living there or visiting:
Does anyone in your household have allergies to animals?

Does anyone in your household have allergies to animals? yes no
If someone has allergies, please explain:
Please provide two personal references. Please do not include household members:
(name, phone number & relationship)
# 1
Please provide two personal references. Please do not include household members:
(name, phone number & relationship)
# 2
(A) Personal Pet Profile:
Please list ALL pets currently a part of your household:
Pet's name
Dog/Cat/Breed
Age/Sex
Altered (Y/N), last date vaccines given?
Where does pet sleep?
List history of medical issues of the above pets, by line number:
1. Pet 1 - 2. Pet 2 - 3. Pet 3 - 4. Pet 4 - 5. Pet 5 -
How many hours per day are your pets left unsupervised?
How are they contained when left unsupervised?
Your veterinarian’s name and phone number:
(B) Relevant Experience/Information
Please list any/all other foster or rescue groups that you are affiliated with:
Does your property have a pool?
Is your property fenced?
If yes, what type of fence (wood, chain link, block ect)
How high is the fence at it's lowest point?
Give a brief description of your experience with very young, ill, injured, and/or un-socialized animals
Please describe the area where the foster animal(s) will be kept and cared for:
How many hours per day will the animal be alone on a regular basis or without an adult caregiver?
Have you ever raised a puppy?

Have you ever raised a puppy? yes no
Sometimes animals become ill while in foster care. If this situation arises, are you willing and able to administer medication?

Sometimes animals become ill while in foster care. If this situation arises, are you willing and able to administer medication? yes no not sure
Do you have experience administering medication to animals?

Do you have experience administering medication to animals? no if you have experience medicating animals, please explain:
Will you enroll in obedience training?
(C) Choices/Preferences:
What is the maximum time you are able to foster?
How many animals are you willing to foster at a time?
How did you hear about our program?
Why do you want to be a foster parent?
I certify that the above information is true and correct. I understand that any falsification of the above information may be grounds for denial of this application or termination of my volunteer status. I acknowledge that this application remains the property of BARX Rescue Squad and Resource Center. I authorize the rescue to conduct an on-site inspection of the premises where the animal(s) will be kept.
Applicant typed signature(s)
Date
Applicant typed signature(s)
Date
Please sign in the box:
I understand this is a legal representation of my signature.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Please sign in the box:
I understand this is a legal representation of my signature. Sign in the box:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Burttschell Rescue Ranch Foster Application

Burttschell Rescue Ranch Foster Application

(A) Personal Pet Profile: Please list ALL pets currently a part of your household:

(B) Relevant Experience/Information

(C) Choices/Preferences:

(A) Personal Pet Profile:
Please list ALL pets currently a part of your household: