Foster Application: Senior Dog Rescue of Oregon, Philomath

SENIOR DOG RESCUE of OREGON
PO Box 1051, Philomath, OR 97370-9293
(541) 929-4100 Email: faria@pioneer.net

Foster Application

* = required fields

Name:*

Address:*

Address 2 (optional):

City:*

State/Province:*

ZIP/Postal code:*

Home Phone
(with area code):*

Cell Phone
(with area code):

E-mail Address:*

Number of adults in home:*

Number/ages of children in home:*

PETS IN THE HOME

Number, breed, sex and age of Dogs:*

Cats:*

Other pets:*

Are all your pets spayed/neutered?* Yes    No

Are all your pets currently vaccinated?* Yes    No

Where do your pets live?* Indoors    Outdoors    Combination
Other (please explain)

FOSTERING INFORMATION

Why are you interested in becoming a foster home?*

What types of dogs are you willing to foster? (check all that apply):* Females    Males    Adults    Puppies
Abused/Neglected    Special Needs (blind, deaf, etc.)

How many dogs are you able to foster at one time? *

Are there any restrictions such as weight, temperament, etc.? Please explain.*

Other information:

As a foster home, are you willing to provide daily food, water, exercise and routine care that a foster animal requires?* Yes    No

Thank you!

By submitting this application, I certify that all of the information I have provided is true and complete to the best of my knowledge.

You will be returned to the Senior Dog Rescue of Oregon main web page.



We reserve the right to refuse any applicant. Thank you for taking the time to complete this Questionnaire which helps us to make the best possible placement for all concerned.

Senior Dog Rescue of Oregon
P.O. box 1051 • Philomath, Oregon 97370-9293
(541)929-4100 •

Name:*
Address:*
Address 2 (optional):
City:*
State/Province:*
ZIP/Postal code:*
Home Phone (with area code):*
Cell Phone (with area code):
E-mail Address:*
Number of adults in home:*
Number/ages of children in home:*
PETS IN THE HOME
Number, breed, sex and age of Dogs:*
Cats:*
Other pets:*
Are all your pets spayed/neutered?*	Yes No
Are all your pets currently vaccinated?*	Yes No
Where do your pets live?*	Indoors Outdoors Combination Other (please explain)
FOSTERING INFORMATION
Why are you interested in becoming a foster home?*
What types of dogs are you willing to foster? (check all that apply):*	Females Males Adults Puppies Abused/Neglected Special Needs (blind, deaf, etc.)
How many dogs are you able to foster at one time? *
Are there any restrictions such as weight, temperament, etc.? Please explain.*
Other information:
As a foster home, are you willing to provide daily food, water, exercise and routine care that a foster animal requires?*	Yes No