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Foster Application

I/We are applying to: *

Gender Preference:

Leave blank if no preference

Preferred Dog Age: *

check all that apply

First Name: *

Last Name: *

Street Address:

City:

State:

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Postal Code:

Phone (home): *

Phone (work): 

Phone (Mobile):

Email: a copy of your submission will be emailed to you if email provided

Current Employer:

Job Title:

Residence

Residence Information:

Please describe where you live

Rental/Apt is OK for Pet?:

Only answer this question if you are a renter.  Yes indicates that you have your landlord's permission to keep a dog.

Landlord name and number (if renter):

City Limit for Pet:

It will be necessary for you to know if there is a limit of dogs (pets) imposed by a local ordinance.  Please check with your village or city.

Do you have a fenced yard?:

Yard Description:

Tell us about your children, including ages:

(if they reside in household dog will be kept)

Do you have other pets?: *

Tell us about your other pets (species, breed, age).  Enter none if no other pets: *

If you have other dogs, please tell us the breed, gender, age, spayed/neutered for each.

What are you currently feeding your other dog(s) or plan to feed your dog?: *

Note:  We are a holistic rescue and all dogs in our care are fed a naturally sourced raw diet. Note: Not providing an answer will result in an automatic denial

What do you use for flea and tick prevention?: *

Have you owned a Cavalier previously?: *

What will be your Foster exercise plan?: *

How and where will your Foster exercise and relieve itself?

Where will your Cavalier be allowed during the day?: *

Please check the location in your house that your Cavalier will have access to during the day.

How many hours a day on average will your Cavalier spend without a human?: *

I understand that rescued Cavaliers may...*

Please check the boxes that you agree are common traits of a rescued Cavalier.

 Veterinary Reference: *

Please provide name, address, city, state, zip, office phone and email for your veterinarian reference.

Personal Reference #1: *

Please provide name, address, city, state, zip, phone and email for your personal reference.

Readiness to foster a Cavalier self rating:

Foster Signature: *

I certify that information contained herein is true.  I recognize that completion of this application does not guarantee placement of a Cavalier in my home.

(Type full name in box)

How did you find Cavalier Rescue Midwest?:

Where will your Cavalier be allowed to sleep?: *

Please check the location where your Cavalier will sleep

How many hours a day maximum will your Cavalier spend without a human?: *

Accepting of Fosters with special needs?: *

Are you willing to accept a Cavalier that has been diagnosed as having a medical need that will require daily medications and frequent visits to veterinarians or specialists?

Fosters in need of training?: *

Are you willing to accept a Cavalier that has behavior problems and might require special training?

Willing to accept neglected or abused Fosters?: 

Personal Reference #2: *

Please provide name, address, city, state, zip, phone and email for your personal reference.

Note from Applicant: 

Foster Date: *

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