Houston Sheltie Sanctuary, Inc.
Rescue Program
After you have read the description of our foster home program, please complete the
questions below, sign, and return to Houston Sheltie Sanctuary, Inc., using one of the
methods at the end of the form. Thank you for helping us with this greatest of
rescue needs.
Name: _________________________________________
Address: ____________________________________
(Apt. #): _________________
City: ___________________ State: ____ Zip: ________
Home Phone with Area Code:____________________
Occupation: _______________________________
Work Phone with Area Code: ____________________
Mobile Phone with Area Code:
E-mail: ____________________________
1. Do you live in a house? _____ Apartment? ______ Condo?
_____
[For safety reasons, HSS does not
place our Shelties in mobile/trailer homes.]
Do you rent? _____ Own?_____
If you rent, do you have the landlord's permission to keep a dog? _______
[Please
attach the form to your application]
If you rent, do you understand the dog must be exercised on a leash in a safe place? ______
Do you have a yard? ______ Is it fenced? _______
[Single dwelling homes must have a fence to protect sometimes nervous rescued
Shelties that might
tend to
bolt]
What type of fencing? ______ chain ______ wood _______ other (please describe)
2. Is someone home during the day? _______ Please
explain:
3. What provisions will be made for your foster Sheltie if nobody is home during the day?
Loose inside? _______ In crate? _______
[Our rescued Shelties must be kept in doors]
4. Where will the dog sleep? Please explain:
5. Please explain your responses below. During the last two years:
a) Have you lost a pet (not through death)?
b) Have you had one poisoned?
c) Have you had an animal killed by a vehicle?
d) Have you had an animal die due to disease?
If yes, what did the animal die of?
6. Do you have children at home? Yes ______ No ______
Number: _____ Age(s): _______
[HSS trusts that your children are experienced with and kind to animals.
Please note: Because we cannot know all the personalities and behaviors of the
children, HSS will not place our dogs in homes that have a baby sitting / day
care home
business.]
7. Do you have other pets at home? Yes ______ No_____ Number: _____ Ages(s): ______
If Yes, are the pets
neutered? Yes ______ No _____
[Due to the many health benefits accruing
from spaying and neutering, as well as to prevent accidental litters, we
require that all resident pets must be neutered/spayed. However, we do
welcome knowledgeable, professional breeders who are members of the ASSA and
their local breed clubs and who would like to work with our program to help our
Shelties.]
If Yes, are the pets vaccinated and on heartworm preventative? Yes_____ No_____
If Yes, do your pets get along with other dogs? Yes _____ No ______
8. HSS will provide all medical care, heartworm and
parasite preventative. Are you prepared to assume the responsibilities of feeding,
bathing, grooming, and caring for your rescue Sheltie, including emotional rehabilitation
for a traumatized dog and crating for a dog going through heartworm treatment?
Yes
______ No ______
9. Will you follow all veterinarian instructions provided and administer all prescription medications and H/W preventative to your foster?
Yes ______ No ______
10. Are you prepared to keep your foster crated if going through H/W treatment?
Yes ______ No ______
11. Are you prepared to assume the responsibilities of contacting HSS officials for any medical emergencies? (For example, if a dog is going through Heartworm treatment and begins throwing up and becomes listless, this may be an emergency).
Yes ______ No ______
12. Do you agree that HSS Coordinators make all medical and adoption decisions for our program dogs?
Yes______ No ______
13. Will you let HSS officials know if you are planning to take your foster out of town or state for family visits or recreation?
Yes ______ No ______
14. Though HSS does not accept vicious dogs into our program, we do not know the histories of many of our rescues. Are you prepared to contact HSS immediately if your foster dog bites anyone or injures another pet? Yes ______ No ______
15. Will you keep the dog confined in a fenced yard when let outdoors, walk/exercise the dog regularly, and allow the dog indoors?
Yes
______ No ______
16.
17. Do you understand that Shelties can be shy and aloof with new people? Yes _____ No: ______
18. Do you understand that only HSS officials may place your foster Sheltie in an adoptive home?
Yes _______ No _______
19. Foster parents are encouraged to maintain an 'aunt' or 'uncle' relationship with the dog in their care; but it does occasionally happen that the foster parent and dog bond so completely that adoption into this home is best for the dog and family, which we would be happy to work with. Do you understand that if you wish to adopt your foster Sheltie, you must complete the adoption papers and pay the fee(s) listed on the adoption description and application pages?
Yes ______ No _______
20. Are you willing to allow a Houston Sheltie Sanctuary, Inc. Rescue Program representative to visit your home by appointment?
Yes: ______ No: _______
21. Name and phone number of your Vet:
_________________________________________________
I hereby authorize the veterinarian named herein to release information about me or my pet(s) to Houston Sheltie Sanctuary, Inc. as necessary to evaluate this application.
22. How did you hear about Houston Sheltie
Sanctuary, Inc. Rescue Program?
Vet, Clinic, or Shelter Referral
_________ (Name: _________________________)
Breeder __________ (Name: _________________________)
Dog/Obedience Club ________ (Name: _________________________)
Another Rescue Group ______ (Name: _________________________)
Friend/Neighbor _______
Other
_________ (please explain)
I am in full agreement with the Houston Sheltie Sanctuary, Inc.
Rescue Program Foster
Care Responsibilities. By signing below I am attesting to the
truthfulness of my answers.
Date: ________________ Signature: __________________________________
Please print, complete, and return to
Houston Sheltie Sanctuary, Inc.
PO Box 840235
Houston, TX 77284-0235
OR FAX to
(281) 859-0146
OR send as e-mail copy-paste or attachment to
Joan
or Linda or
Connie If choosing this
option, download the form, open and complete it, resave, and send to one or all of the above
e-mail addresses. Please be sure you give your e-mail post a clear subject
heading so we know what it is about when it comes into our e-mail boxes.