Shorewood Cocker Rescue's Foster Application

Name:

Address:

City:

State: Illinois Indiana Iowa Michigan Minnesota Missouri Ohio Wisconsin

Zip Code:

Telephone: (Home) (Work) (Fax)

Email:

How did you hear about us?

List members of your household.

Name: Age:
Name: Age:
Name: Age:
Name: Age:
Name: Age:
Name: Age:

Do you rent or own?
Rent
Own

Do you have a fenced in yard?
Yes
No

If no, describe how you plan to contain your dog in a manner that will prevent it from running off or getting hit by a car.

Are you willing to provide some training that might be needed?
Yes
No

Are all members of your family willing to accept your desire to become a foster parent?
Yes
No

What made you consider becoming a foster cocker parent?

Have you ever had or fostered a Cocker Spaniel before?
Yes
No

If yes, please tell me all of its good and bad points.

If no, are you aware of the grooming requirements and common health problems?
Yes
No

Are you willing to foster a dog with a special condition such as:
Blindness or vision impairment? Yes No
Epilepsy? Yes No
Hypothyroid? Yes No
Submissive wetting? Yes No

What other pets have you owned (please give breed if dog, gender, and age)?

Do you own them currently or where are they now?

If deceased what was the cause of death?

Are the other animals you currently own spayed or neutered?
Yes
No

What qualities are you looking for in a foster dog?

What kind of doggie behaviors do you feel you would be unable to tolerate in a foster?

If the cocker will be home alone during the day, how many hours per day?

Where will your foster(s) be when you are at home/not at home?

Do you agree to a pre-placement home visit and/or follow-up visits?
Yes
No

Do you know how to or are you willing to crate train a cocker?
Yes
No

Please provide the following names and numbers:
Vet:

Phone number:

Groomer:

Phone number:

Personal reference:

Phone number:

Date Applied:

Additional comments and/or questions:

Your application will be processed and responded to as soon as possible.

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