Foster Application

Thank you for your interest in becoming a foster volunteer for BRBCR! Please fill out the following Foster Application and Release Form. Our volunteer coordinator will be in touch with you soon.

PLEASE PROVIDE INFORMATION ABOUT YOU

Name *

First

Last

Primary Phone *

Email Address: *

Address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Your Age: *

• Under 21
• 21 - 50
• Over 50

ABOUT YOUR ABILITY TO FOSTER

What previous experience have you had with Border Collies? *

Select any of the following that best describes the foster dog you feel would fit in your lifestyle

Age: *

• Puppy
• Young Adult
• Adult
• Senior

(Check as many as applies)

Activity: *

• Companion
• Active Pet
• Sport Competitor
• Working Dog

(Check as many as applies)

Gender: *

• Male
• Female
• No Preference

Other:

• Crate trained
• House trained
• Kid-friendly
• Dog-friendly
• Cat-friendly
• Livestock-friendly

(Check as many as applies)

Maximum length of foster care: *

• Overnight
• Up to 1 week
• Indefinite

(Check as many as applies)

Describe in as much detail as possible the daily routine with your foster dog.

Morning Routine: *

Afternoon Routine: *

Evening Routine: *

Where will your foster dog be kept during the day? *

How many hours will your foster dog be alone during the day? *

If your foster dog will be alone for more than 4 hours, what are your plans for taking care of the dog’s needs? *

Where will your foster dog be kept at night? *

How will your foster dog be cared for during extended absences? *

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HOUSEHOLD INFO

Select the following that best describes your home:

Location: *

• Urban
• Suburban
• Rural

Type: *

• Townhouse/Condo/Duplex
• Single family home
• Home with acreage

Yard: *

• No yard
• Yard, no fence
• Fenced yard

Do you rent or own? *

• Rent
• Own

Describe your yard (include size, type of fencing and height of fencing): *

How many adults live in your household? *

How many children live in your household? *

Is there anyone home during the day? *

• Yes
• No

Who is at home during the day?

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HISTORY & REFERENCES

Pet History

List the pets you currently own or have owned in the past.

Pet Name

Pet Type/Breed/Gender

Example: Dog / Border Collie / Male

Pet Age

Pet Status

Pet Status

Pet StatusRemove item

Pet Status

Current

Past

If any of your pets are not spayed or neutered, please explain why.

Veterinarian Info

Veterinarian Name *

Veterinarian Phone *

References

Please provide three references who are not living with or related to you.

Reference Name 1 *

Reference Phone 1 *

Reference Relationship 1 *

Reference Name 2 *

Reference Phone 2 *

Reference Relationship 2 *

Reference Name 3 *

Reference Phone 3 *

Reference Relationship 3 *

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Have you or anyone in your household been convicted of animal cruelty, neglect, or abandonment? *

• Yes
• No

Have you ever re-homed or given up a dog or cat to an animal shelter, SPCA or pound? *

• Yes
• No

Please Explain:

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LIABILITY RELEASE STATEMENT *

• By checking this box I agree to the following: I certify that I have never been convicted of animal cruelty, neglect, or abandonment. I release, discharge, and hold harmless Blue Ridge Border Collie Rescue, Inc., all individual volunteers, and anyone else associated with Blue Ridge Border Collie Rescue, Inc. from any charges or claims arising from my participation in any action related to the activities of Blue Ridge Border Collie Rescue, Inc.

Signature *

Clear Signature

Use your mouse or cursor to sign this document.

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