First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
County*
Email*
Home Phone*
Work Phone* x
Cell Phone*
Birth Date of Applicant:
How long have you lived at this address:
Are you planning to move to another home in the near future (explain):
Are you in the armed forces (do you live on or off post):
How did you hear about BPRS:
Do you rent or own your home:
Please provide name and phone number of your landlord:
RENTERS: Do you have written permission from your landlord to foster a bully breed:
HOMEOWNERS: Does your insurance have breed restrictions.
HOMEOWNERS: What is the name of your insurance carrier?
How many non-family adults and children will be in frequent contact with your foster dog:
Who will be the main caretaker of the foster dog:
Are your children respectful towards a pet or when interacting with an animal.
Does anybody who is in regular contact with the foster dog has any allergies to dogs:
Which animal are you interested in fostering: Choose an animal: Birdie Bonnie Frankie Ms. Patmore Splash Star Sybil Tanner (Senior) Tara
What temperament are you looking for (i.e. calm, playful, good with other animals etc)
Is this the first time you are taking care of a dog:
If owned before, what other breeds have you lived with:
What is your experience with bully breeds (i.e. Pit Bull type dogs):
How many other animals currently live in your home or visit frequently (please list all by species, age, breed and how long you have had it):
Are your current pets friendly with other dogs:
Please list and explain what happened to previous pets which no longer live with you:
Adding a dog to your home will change and add inconvenience to your daily routine. Are you aware of this and do you agree to accommodate your lifestyle to the needs of the foster dog until it has been adopted:
What kind of home do you live in:
Is your yard fenced (if yes what height and type of fence do you have?:
How do you plan to exercise the foster dog:
How much time will the animal spend alone during the day:
Where will the animal be kept when you are not home?:
Where will the animal sleep?:
How active is your lifestyle outside of work?
How will you involve your foster dog into your daily activities:
Do you realize even with a fence that dogs need to be leash-walked every day?:
Have you ever taken one of your pets to a shelter? If yes, please describe the circumstances:
Have you ever been charged with animal cruelty?
VETERINARIAN: Please provide name and contact information for your current or previous veterinarian.
PERSONAL REFERENCE: Please provide two references including name, relationship and phone number (family members or relatives are not acceptable):
EMPLOYMENT: Please list place of employment for yourself including the phone number, length of time at the job, and address:
Please list place of employment for your spouse or significant other including the phone number, length of time at the job, and address:
I certify that the information entered is true and correct. Enter your full name and date to confirm:*
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