If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Mutt Madd-ness Foster Form In order to be a foster home we do need some basic information for our records. We take privacy very seriously and Do Not sell any information given. If you wish to foster dogs for Mutt Madd-ness please fill out this form completely. Applicants must be 25 years or older. All fields are required. Incomplete applications will be denied. For applications selected, a reference/vet-check and home visit will be done. Applying for a Specific Dog, please provide name? General Application, (non specific dog) type yes or no. Note any preferences in dog, number, size, etc.: First Name Last Name Address 1 Address 2 City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code Email Home Phone Work Phone Mobile Phone Contact Preference Email Office Phone Home Phone Mobile Phone Place of Employment How many years have you worked there? Who will be the dog's main caregiver? Have you ever fostered or are currently fostering? (check for yes) If yes, please explain. Have you ever had an application declined for adoption or foster of an animal from an animal rescue/animal control facility? (check for yes) If yes, please explain. Do you live with: Spouse Roommate Parents Alone How many people live in your home? Are there children under 21? (check for yes) How many under 21 and what are their ages: Is anyone allergic to dogs? (check for yes) Other dogs and animals in your house: If you have pets are they all spayed/neutered and current on vaccinations? (check for yes) If not, please explain. What is your home? Apartment Townhouse Private home If you are renting, please provide landlord's name and phone number for verification: Do you own or rent? Are there breed restrictions in your community? (check for yes) If you are in a private home, is your yard fenced? (check for yes) If yes, please describe fencing style, location and height. Where do you plan to house the foster dog? Where would they sleep at night? Please explain. How long will the foster dog be left alone on a day-to-day basis? Are you willing to work with your foster dog on behavior, potty training, etc. Please explain. How would you correct the dog for misbehavior or a potty accident? Two References including current vet (name and phone number) Please provide your comfort level in managing/caring for a dog. Behavioral, medical, puppy training, etc. Do you agree to care for, help market and bring the dog to regular adoptions and any medical visits? (check for yes) If no, please explain. In consideration of Mutt Madd-ness, hereinafter the "Corporation's", acceptance of my services as a Rescue Volunteer, Foster Home, or Special Volunteer, I agree that I, my assignees, heirs, distributees, guardians, and legal representatives forever release and shall not make a claim against, sue, or attach the property of the Corporation, its officers, directors, volunteers, committee members, members, employees, agents, heirs, successors and assigns for any actions, causes of actions, suits, liabilities, claims, demands, damages or causes of any kind or nature whatsoever, whether presently existing or arising in the future, whether known or unknown, which arise out of or are based upon any fact, matter, claim or thing involving my services as a volunteer. I agree to indemnify and defend the Corporation, its officers, directors, volunteers, committee members, members, employees, agents, heirs, successors and assigns against and save them harmless from any and all demands, claims, causes of action, or judgments, and any and all expenses (including, without limitation, attorneys fees) incurred in investigating or resisting the same, for injury to person, loss of life, or damage to property occurring during the term of my services as a Rescue Volunteer, Foster Home, or Special Volunteer, and until all applicable statutes of limitation expire, arising out of any act, omission, or neglect of the Corporation, its officers, directors, volunteers, committee members, members, employees, agents, heirs, successors and assigns. By submitting this application, I declare that all of the above information I have given is true and complete. I agree to foster, volunteer or provide other services for Mutt Madd-ness. Full Name * Date Agreed to and Submitted On *