Section A:

PERSONAL INFORMATION

1. NAME:

2. ADDRESS:

3. COUNTY:

4. CITY: STATE: Florida Georgia Alabama Louisiana ZIP:

5. HOME PHONE: WORK PHONE: CELL PHONE:

6. E-MAIL:

7. WHERE IS THE NEAREST ANIMAL SHELTER?

8. YOUR AGE RANGE: Under 18 18-20 21-25 26-35 36-45 46-55 Over 55

9. FOR STATISTICAL PURPOSES WHAT IS THE OCCUPATIONS OF ALL ADULTS IN THE HOUSEHOLD:

10. DO YOU CURRENTLY FOSTER OR VOLUNTEER FOR ANOTHER RESCUE? YES NO

Please indicate what you would be interested in doing as a volunteer for the Siberian Husky Rescue of Florida, Inc.(you can select more than 1 option):

11.

ANIMAL CONTROL LIAISON

LETTING RESCUE KNOW OF SIBERIANS IN NEED IN YOUR AREA

DOING REFERENCE CHECKS AND HOUSE INSPECTIONS OF POTENTIAL ADOPTERS IN YOUR AREA

IDENTIFYING DOGS REPORTED IN YOUR AREA AS PURE SIBERIANS

PROVIDING TRANSPORT SERVICES TO THE RESCUE

POSTING FLYERS

ADMINISTARTIVE/OFFICE WORK

RETURNING PHONE CALLS OR EMAILS

PR/FUNDRAISING/MARKETING ACTIVITIES

OTHER (Please Describe)

12. WOULD YOU BE INTERESTED IN FOSTERING? YES NO

If you have said YES to question number 12, please complete this application in it's entirety. If you said NO to number 12, then proceed down to Section F.

13. IF YES, HOW LONG COULD YOU FOSTER FOR? 2-4 WEEKS 1 - 4 MONTHS UNTIL ADOPTED

14. WHAT MADE YOU INTERESTED IN FOSTERING A SIBERIAN HUSKY?

Section B

VET'S INFORMATION (Most Recent in past 2 years.)

1. Vet's NAME::

2. Vet's ADDRESS:

3. Vet's PHONE NUMBER:

4. IF YOU HAVE USED THIS VET FOR 1 YEAR OR LESS PLEASE PROVIDE PREVIOUS VET INFORMATION:

5. MAY WE CONTACT YOUR VET? YES NO

6. DO YOU GET ANNUAL SHOTS FOR YOUR PETS? YES NO

7. DO YOU GET AN ANNUAL HEARTWORM TEST ON YOUR PETS? YES NO

8. DO YOU GET AN ANNUAL PHYSICAL EXAM FOR YOU PETS? YES NO

9. DESCRIBE YOUR ANNUAL VET VISIT, I.E. For shots, routine physical, etc.

10. ARE YOUR CURRENT PETS SPAYED/NEUTERED? YES NO

11. DO YOU USE HEARTWORM PREVENTATIVE? YES NO

12. IF YES WHAT BRAND? Heartgard Interceptor Sentinel Revolution ProHeart 6 (6 mth shot) Ivomec

13. DO YOU USE FLEA/TICK PREVENTATIVE? YES NO

14. IF YES WHAT BRAND? Frontline Advantage Program Revolution K9 Advantix

CURRENT PET INFORMATION

15. DESCRIBE CURRENT PETS:

16. HOW DO YOU FEED YOUR PETS:

17. HOW WILL YOU INTRODUCE THE NEW DOG TO YOUR FAMILY AND CURRENT PETS:

Section C

RESIDENCE INFORMATION

1. HOME STYLE: Single Family Home Multi Family Home Townhouse Condominium Mobile Home Apartment DESCRIBE YOUR COMMUNITY: Suburban Urban Rural

2. DO YOU HAVE A FENCED IN YARD? YES NO

3. IF YES PLEASE DESCRIBE IN DETAIL:

4. DO YOU OWN OR RENT/LEASE? OWN RENT/LEASE

5. HOW MANY PEOPLE LIVE IN YOUR RESIDENCE:

6. HOW MANY CHILDREN LIVE WITH YOU OR VISIT FREQUENTLY:

8. ANY DEED RESTRICTIONS? YES NO

9. DO YOU OWN OR RENT/LEASE? OWN RENT/LEASE

IF YOU RENT PLEASE GIVE THE FOLLOWING (*Note: A letter from your landlord indicating a dog of this size is authorized in your home will be asked for. Your application cannot be processed without this information)

10. LANDLORD/PROPERTY MANAGER'S NAME:

11. LANDLORD/PROPERTY MANAGER'S ADDRESS:

8. LANDLORD/PROPERTY MANAGER'S PHONE NUMBER:

12. ARE YOU ALLOWED PETS OVER 50 LBS? YES NO

13. HAVE YOU EVER OWNED A SIBERIAN HUSKY? YES NO

14. HOW WOULD YOU DEAL WITH A DOG THAT SHEDS A LOT?

15. HOW MANY HOURS A DAY WILL THE DOG BE ALONE?

16. WHERE WILL THE DOG BE KEPT WHEN NOBODY IS HOME? INDOORS OUTDOORS CRATE KENNEL RUN BACKYARD BACKYARD W/ ACCESS TO GARAGE OR ROOM FREE ROAM OF THE HOUSE
You can select multiple items by holding the "CTRL" button down

17. WHERE WILL THE DOG BE KEPT AT NIGHT? INDOORS OUTDOORS CRATED KENNEL RUN FREE ROAM OF HOUSE A DOG BED OUR BED BEDROOM FLOOR WHERE EVER IT WANTS

18. DESCRIBE PREVIOUS PETS YOU HAVE OWNED IN THE PAST:

19. ARE YOU WILLING TO CRATE TRAIN THE FOSTERED SIBERIAN? YES NO DO NOT BELIEVE IN CRATING

20. ARE YOU WILLING TO DO SOME BASIC OBEDIENCE TRAINING WITH THE FOSTERED SIBERIAN? YES NO

21. WHAT WOULD YOU DO IF A PROBLEM ARISES WITH THE FOSTERED SIBERIAN?

22. WHAT WOULD YOU DO IF THE FOSTER SIBERIAN GOT LOST OR STOLEN?

23. Have you ever been convicted of animal cruelty or had a court order against you preventing you from owning any animals even for a short period of time? YES NO

Section D

THE SIBERIAN TO BE FOSTERED

WHAT SEX DO YOU PREFER?: MALE FEMALE NO PREFERENCE

WHAT AGE ARE YOU WILLING TO ACCEPT?: SENIOR AGES 7 AND UP ADULT AGES 4-6 YEARS YOUNG ADULT AGES 1-3 YEARS PUPPY AGES 6-11MONTHS NO PREFERENCE

CHARACTERISTICS NEEDED TO BE IN YOUR HOME: HOUSEBROKEN PRESCHOOL CHILDREN SCHOOL AGE CHILDREN TEENAGERS SENIORS GOOD W/SMALL DOGS GOOD W/LARGE DOGS GOOD W/CATS GOOD W/LIVESTOCK
You can select multiple items by holding the "CTRL" button down

WHY DO YOU WANT TO FOSTER A SIBERIAN HUSKY?

Section E

REFERENCES (*We need at least 2 references not related to you, ie.other pet friends, pet sitters, long term friends, coworkers, etc.)
3 references MUST be completed with phone numbers or your application will be denied!

REFERENCE #1:

REFERENCE #2:

REFERENCE #3:

Section F

By filling out this Volunteer/Foster Application I/we the undersigned are aware that this does not guarantee me/us a volunteer/foster position from Siberian Husky Rescue of Florida, Inc. If I/we are not accepted to be a Volunteer/Foster I/we will not misrepresent myself/ourselves as Volunteers/Fosters and collect donations, applications or do any other activity Siberian Husky Rescue of Florida, Inc. as an organization is involved in or participates in.

SIGNATURE OF APPLICANT:

DATE:

SIGNATURE OF CO-APPLICANT:

DATE:

If applying to be a Foster Home All Fields must be complete in order to submit form.