Name:	Date:
Address:
City:	State:   Minnesota Nebraska South Dakota   Zip:
Day Phone:	Evening Phone:
Email:

Do you live in a:     House   Apartment   Duplex   Townhouse/condo   Mobile

Do you own or rent:     Own   Rent         Name and phone of landlord:

Number of adults in household:    Number of children:    Ages:

Is anyone in your family allergic to dogs:     Yes   No  How will they accommodate:

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What pets are currently in your household?
TYPE	NAME	SPAYED NEUTERED?	KEPT WHERE?	BREED/SEX	AGE	YEARS HAD?
DogCat		YesNo	InOut	FemaleMale
DogCat		YesNo	InOut	FemaleMale
DogCat		YesNo	InOut	FemaleMale
DogCat		YesNo	InOut	FemaleMale
Do any of your current pets have behavioral issues that may affect a foster placement with your family (e.g. dominance, scared of other animals, good with males and females (or one or the other only), not housetrained or crate-trained?)  Yes   No If yes, please describe. This will allow BWBR to try to accommodate these issues.
List your previous pets and describe why you no longer have them.
TYPE	NAME	SPAYED NEUTERED?	KEPT WHERE?	BREED/SEX	AGE	YEARS HAD?
DogCat		YesNo	InOut	FemaleMale
Explanation:
DogCat		YesNo	InOut	FemaleMale
Explanation:
DogCat		YesNo	InOut	FemaleMale
Explanation:
DogCat		YesNo	In   Out	Female   Male
Explanation:

Name and phone of veterinarian:

Why do you want to foster this particular pet/breed:

Do you have any preferences or restrictions for animals that you can/will foster (i.e., beagles only, M/F only, etc.):

Do you agree to keep a collar with ID tags, including your contact info, on the pet at all times:     Yes   No

How will you exercise and interact with your foster pet:

How may hours per day will this pet spend alone:    Why:

Where will you keep your foster pet at night:

Where will you keep your foster pet when you are at work:

How will you confine your foster pet outdoors (check all that apply):     Fence, type and height    Kennel Run   Patio   Garage   Leash   Chain/Tie out/Runner   Other

Where will you keep your foster pet when you travel away from home:

What will you do if your foster pet is destructive (digs, chews, etc.):

Do you know you may have to discipline and/or housetrain your foster pet, which may require time and patience. Are you willing and able to commit to any necessary training:     Yes   No

Would you object to a follow-up call/visit from BWBR:     Yes   No

It is my intention to integrate any animal I may foster into my home and life as a pet and companion. I understand that fostering entails a commitment to provide responsibly for the pet's needs while it is in my care. I am over age 18 and I am willing to make this commitment. I am aware that the duration of any dogs foster stay cannot be predicted and could last for some time; that a dog's basic needs alone (non-veterinary) cost hundreds of dollars per year; that my foster will require time each day for training, grooming, exercise, and interaction. I authorize the landlord, if any, and their agents to release to BWBR any information in my rental agreement that pertains to pet owning and keeping. I authorize the veterinarian listed above and their agents to release to BWBR any information pertinent to evaluating my history of pet ownership, if any. I certify that the above information is true. False information will be cause for denial of this application. BWBR reserves the right to deny any adoption for the sake of the animal's welfare. All completed applications are the property of BWBR and will be retained in its files.

I accept the above terms:     Yes   No