Foster Application Form

Name of Applicant *

First

Last

Name of Co-Applicant

First

Last

County of Residence *

PLEASE NOTE: TO BE A FOSTER, YOU MUST LIVE IN CLAY, DUVAL OR ST. JOHNS COUNTIES IN FLORIDA.

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Home Phone

Work Phone

Cell Phone

Email Address *

Email

Confirm Email

Alternate Email Address

Email

Confirm Email

Do you work? *

Yes
No

What days and hours?

What is your place of employment? If self-employed, please describe.

Does the co-applicant work?

Yes
No

What days and hours does the co-applicant work?

What is the co-applicant's place of employment? If self-employed, please describe.

Any children in household? *

Yes
No

TO BE A FOSTER, YOU MUST NOT HAVE CHILDREN UNDER 5 YEARS OF AGE.

What are their ages?

Do other children (grandchildren, nieces/nephews, neighbors) visit your home? *

Yes
No

What are their ages?

Have you owned a pet in the past? *

Yes
No

Please provide breeds/species and where the pet is now.

Do you have any pets now? *

Yes
No

Please provide ALL names, ages, sex, breeds & species.

Name of Veterinary *

Phone # of Veterinary *

Please list the names/species of your pet(s) both past and present that go to or went to this vet AND the owner's name under which the pet is listed. *

Where will the Golden be kept during the day? *

Where will the Golden be kept at night? *

Where will the Golden be kept when no one is at home? *

Who will provide the most care and exercise for the dog? *

Do you have a fence? *

Yes
No

Please describe fence (i.e. height, type, area of yard covered).

Do you have a doggie door? *

Yes
No

Does your home have stairs? *

Yes
No

We ask this so we can avoid placing those dogs that have mobility problems in homes with stairs.

If your home has stairs, please describe.

Number of flights, carpeted/hardwood, etc.

Do you own a crate? *

Yes
No

Are you familiar with Heart Worm/Flea Prevention meds? *

Yes
No

Are you able to transport a dog to vet appointments? *

Yes
No

Comments

How did you hear about GREAT?

Foster-to-Adopt Terms

I/We Acknowledge and Agree.

If the foster family continues to foster a dog until it is available for adoption, they will be given first consideration to adopt that dog at the adoption fee designated by the rescue if they have followed vet protocol with our vet and are deemed a good fit by the rescue.

Foster Agreement Terms *

I/We Acknowledge and Agree.

By checking the above box, I/we acknowledge and agree to the following: I/we agree to Foster a dog rescued by G.R.E.A.T. Rescue Of NE Florida, Inc. (G.R.E.A.T) and agree to: 1. Provide care, food and companionship to the fostered dog. 2. Not leave children or pets alone with the fostered dog. 3. Not leave the dog alone in the yard or off leash. 4. Not allow the dog to be approached by people or other animals until I am confident that it is not aggressive or fearful of others. 5. To care for the dog if it becomes ill and provide the medical care designated by a G.R.E.A.T. Veterinary. 6. Take the dog to scheduled medical appointments (funded by G.R.E.A.T.) at the rescue’s designated veterinary hospital. 7. Foster family also understands that the dog(s) may become frightened, be food aggressive, not be comfortable being touched, hugged or in a boisterous atmosphere. It will be allowed to join in activities only as it feels comfortable. 8. Fostered dog will wear a collar and identification tag at all times. 9. Foster family agrees to the examination of the dog(s) by a rescue representative at any time, and acknowledges that the rescue has the right to reclaim the dog(s) at any time for any reason. 10. Fostered dogs are the property of G.R.E.A.T. RESCUE OF NE FLORIDA INC. and cannot be sold, given away, exchanged, placed or adopted without prior consent from G.R.E.A.T. 11. Foster will immediately notify GREAT Rescue of any new health issues, concerns and aggression the fostered dog may display.

Foster Agreement *

I/We Acknowledge and Agree.

By checking the above box, I agree to the following: By checking this box, I/we acknowledge that the information presented herein is true and accurate. I/we have read and agree to the terms of the foster agreement and agree that G.R.E.A.T. Rescue of NE Florida Inc., and those who volunteer on its behalf, are not liable or responsible for any mishap(s) that may occur while the rescued dog is in our foster care/adopted.

Date / Time of Submission *

Date

Time

Captcha *

=

Submission Notes

A CONFIRMATION PAGE WILL APPEAR UPON SUCCESSFUL SUBMISSION. IF AFTER CLICKING SUBMIT, ONE OR MORE ERRORS ARE FOUND, THE PAGE WILL SCROLL UP TO THE FIRST ERROR AND THE ERROR MESSAGE "This field is required." WILL APPEAR. PLEASE CORRECT ANY ERRORS AND SUBMIT AGAIN. IF YOU STILL HAVE PROBLEMS, PLEASE SEND AN EMAIL TO info@greatrescue.org TO REQUEST AN ELECTRONIC VERSION OF THE FORM.