PLEASE READ: **North Carolina Rottweiler Rescue Reserves The Right To Deny Any Application For Any Reason

North Carolina Rottweiler Rescue Application to FOSTER

Personal Information: Name:_________________________________ Age: ____________ Spouse: _________________________________ Age: _____________ Address: ________________________________ ________________________________ ________________________________ Phone: _________________________Home _________________________ Your Work _________________________Spouse’s Work Email: _________________________________ Employer: ________________________________________________ Spouse’s Employer: ________________________________________________ Number of Children: ________ Names Ages ____________________________ ______ ____________________________ ______ ____________________________ ______ ____________________________ ______ Have any of these children been exposed to large breed dog before? _____Yes _____No Have any of these children been biten by a dog? ___ Yes ___ No If yes, please explain the circumstance: Please circle which of the following best describes your current living situation: 1. House Condo Apartment Mobile Home 2. Rent Own Live with parents If you rent, name and phone number of landlord: ________________________________________________________________ 3. City Suburban Country How long have you lived at this address? _____________________ If less than 2 years, please list your previous address: ________________________________________________________________

If you rent:

Does your landlord allow pets? ____ Yes ____ No Is there a pet deposit? _____ Yes _____ No If yes, how much money per pet or per household? Is there a size or weight limit? ____ Yes ____No If yes, what is the limit? What is your landlord's name and phone number? _____________________________________________________________ How long have you lived at this address? _________________

Is there a chance you might move in the next 5 yrs? ___ Yes __No Besides your immediate family, are there others residing in your house? YES or NO If yes, names and relationship: ________________________________________________________________ ________________________________________________________________ Does your home have a yard? YES or NO If yes, is it fenced? YES or NO What type of fence? _______________________________________ How tall is the fence? _______________________________________ Will the gate be locked with a pad-lock? YES or NO If you do not have a fenced yard, are you prepared to walk your dog on a leash for potty breaks and exercise more than 3 times per day, regardless of the weather conditions or time of day/night: ____ Yes ____ No What is the maximum number of dogs/pets allowed by city ordinance? What are your local licensing fees/requirements:?

Have you ever had a pet hit by a car or lost?__ Yes __ No If so, please explain:

Foster Placement Information: Is someone home during the day? YES or NO If no, where will the dog stay while you are gone? ________________________________________________________________ Where will your dog be kept most of the time? Inside Outside Basement Garage Other

(specify):____________________ If kept outside, will you have a dog run and/or dog house? Specify: _________________________________________________________ Where will the dog sleep at night: What will you do with your dog when you need to travel or go on vacation? Would you let the dog outside by itself occasionally if you had a house with lots of land and away from busy streets? YES or NO Do you plan to chain the dog in the yard at any time? ____ Yes ____ No Do you plan to leave the dog in an outdoor kennel at any time? ___Yes __ No Do you own a dog crate? Yes or No If you own a dog crate, what size it is: ________ Are you willing to purchase a crate for your foster dog? Yes or No What steps have you taken to learn about Rottweilers and dog ownership? ______________________________________ ____________________________________________________ ___________________________________________________ Check any of the following you feel are valid reasons for giving away a pet: ___Fleas ___Too expensive ___Having a baby ___Sheds too much ___Moving to another state ___Getting married or divorced ___Chews or destroys household objects ___Children will no longer take care of it ___Found a new place to live but they don't allow pets Will you accept a Rottweiler with Special Needs?__ Yes __ No Do you understand that the dog will take time to adjust to it's new surroundings and that certain behavioral issues might occur? __ Yes __ No Are you willing to work with NCRR to correct these issues? ___ Yes ___ No Have you ever fostered a Rottweiler or any other dog? YES or NO What organization did you foster for? If yes, tell us about your rotts or foster dogs:________________________________________

What sex do you prefer?

male

or

female

Age range? _____________________________________________________ Is there a dog on our web page that you are interested in fostering? If yes, which one? ________________________________________________________________ Why do you want to foster a Rottweiler?_____________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________ Will the Foster Rottweiler be used as a guard dog? Yes or No

What activities do you plan to do with your Foster Rottweiler? ____________________________________________________________________________ ____________________________________________________ Other Pet Information: Do you have any other pets? Name Type (dog, cat, etc.) Age ______________ ___________________ __________ ______________ ____________________ __________ ______________ ____________________ __________ ______________ ____________________ __________ Are your animals/foster pets on heartworm preventative? Yes or No What type? ________________________________________ Current on Vaccinations? ___________ ___________ ___________ ___________

Your veterinarian: Name: ____________________________________________ Phone number: ____________________________________________ If applicable, approximate date of your current pet’s last office visit: ________________________________ Miscellaneous: If you have owned/fostered other dogs and do not now, what happened to them? ____________________________________________________________________________ ____________________________________________________________________________ ________________________________________

Would you allow your children to take a toy or food from your foster dog if approved: Yes______ No _______

If you have pets, how do you plan to introduce your foster dog to your household:

Are you willing to take the time to teach your foster dog basic commands such as: walking properly on leash, sit, come when called and housetraining: _____ Yes _____ No Are you willing to attend adoption events with your foster dog: _____ Yes ______ No If the dog is comfortable with you, will you let it walk off lead or out in a yard that is not fenced in: ____ Yes ____ No Are you familiar with Heartworm Disease: ____ Yes Who have you fostered for in the past: Are you willing to foster a dog until a forever home is found: ___ yes ___ no How did you hear about the North Carolina Rottweiler Rescue Group? ________________________________________________________________ List any Humane Societies, Organizations, Breed or Training Clubs you are associated with: ________________________________________________ We will attempt to provide you with an honest evaluation of temperament on any dog we foster out. Do you realize that often times the complete history of a Rottweiler may not be known and you may encounter some behavioral problems?_____________________________________________________ Are you willing to work with us on correcting these problems?________________ The length of the foster period varies greatly. Some dogs stay in foster care for only a week or so before they are ready to be adopted into a family. Some dogs need more time and attention either physically or psychologically or both, and some dogs just take a while to 'click' with the perfect adopter. We cannot guarantee a foster timeframe. Are you willing to foster a dog until a forever home is found? Yes OR No If not, how long are you able to foster for: _____________________ Please provide three references (no relatives please!): Name Address Phone Number Relationship ____ No

Additional Comments:___________________________________________________________________ ____________________________________________________________________________ _____________ ___________________________ I certify that the information provided on this form is true and correct. I understand that a Home check will be completed before being approved to foster for NCRR. If upon inspection we find

that the information contained in this application to be false, we retain the right to deny your application or remove the animal from your premises immediately. Do you give permission for a NCRR Representative to visit your home prior to and after the fostering period is in effect to do follow up visits on your adopted Rottweiler? ___ Yes ___No Are you currently working with another rescue group to foster a companion pet? ____ Yes ___ No If yes, what is the name of the rescue group? _______________________ Have you applied with another rescue group in the past 24 months to foster a companion pet? ___ Yes ___ No _____ (Please Initial) I certify that the information provided on this form is true and correct and understands that, prior to being approved for fostering a NCRR foster dog, this information will be verified. A home visit will be scheduled and all members of the household must be present. If upon inspection we find that the information contained in this application to be false, we retain the right to deny your application or remove the animal from your premises without a refund of monies paid. I am also financially and physically able to care for this animal. I understand that proper food and boarding care can be costly and I am able and willing to meet these requirements. Approved foster application require a signed Foster Contract by the Foster Family and by the Executive Director of NCRR to be valid. If upon inspection we find that the information contained in this application to be false, we retain the right to deny your application. _____ (Please initial) I agree to notify NCRR of any change of employment, family status, relocation and any other family changes. I, ___________________________ (applicant's name) give _____________________ (Veterinary Clinic) permission to release any and all requested documents on all pets that are or have resided in my household for the last five years from the date of this application to a Representative of NCRR. This authorization will expire 1 year from today, the ___day of ___ 200_.

______________________________________________ __________ Signature (signing this form acknowledges the below statement) Date

Complete entire form and mail back to: NCRR (foster) 5613 Old Ridge Road Raleigh NC 27610

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