FOSTER HOME APPLICATION

* indicates required field
 
* First Name:
Middle Name:
 
 
* Last Name:
 
 
  Spouse's First Name:
Spouse's Middle Name:
 
 
  Spouse's Last Name:
 
 
* Home Phone (include area code):
 
 
* Work Phone (include area code):
 
 
  Work Hours:
 
 
  Cell Phone (include area code):
 
  Fax Phone (include area code):
 
  Best time to call:
 
* E-mail:
 
 
* Street Address:
 
 
* City:
 
 
* State:
(State is required if you live in USA.)
 
 
* Country:
 
 
* Zip/Postal Code:
 
 
* Drivers License State and Number:
 
 
* Do you understand that prior to a Wheaten being placed in your home you will be required to fax a copy of your drivers license. Yes No
 
* Personal reference (no family members please)
 
 
* Personal reference Tel No.
 
 
* Vet Reference
 
 
* Vet Tel No.
 
 
* Why do you want to foster a Soft Coated Wheaten Terrier?
 
 
  Have you previously owned a Wheaten? Yes No
 
* Do you have other pets? Yes No
  If yes, specify type, sex, name and indicated whether each animal is spayed or neutered
 
* Do you have children? Yes No
  If yes, please state their names and ages
 
* Do you agree to never leave the foster dog alone with children or without supervision? Yes No
 
* Is someone home during the day? Yes No
  If no, what is the longest time away?
 
* Do you have a fenced yard? Yes No
 
* Do you agree to not leave the Wheaten unattended in a yard under any circumstances? Yes No
 
* Do you agree to never have the Wheaten off lead while outside your home or fenced yard? This includes parks and “off-leash” dog areas.
Yes No
 
 
* Are you aware of Wheaten grooming needs and do you agree to keep the dogs coat in good condition and free of mats? Yes No
 
* Do you agree to relinquish the dog once a permanent home is found or upon the demand of S'Wheat Rescues? Yes No
 
  Note: In some cases this agreement may be used as a temporary arrangement while both the foster parent and S’Wheat Rescues decide if this arrangement would be acceptable as a permanent adoption. In such cases, after being approved for adoption, foster parent will be allowed to adopt the dog upon filling out an adoption agreement and paying the adoption fee. If however, for any reason, should S’Wheat Rescue decide that the dog is not to be placed in this home permanently, foster family agrees to immediately turn said dog back over to the care of S’Wheat Rescues.
 
* Will you prevent any foster dogs from mating while in your care? Yes No
 
* Do you agree to release S’Wheat Rescues from any liability in the case of dog bite or other injury to either humans or other animals while in your care? Yes No
 
 
* While fostering a Wheaten Rescue you will be responsible for the basic necessities such as food, water and shelter. Veterinary expenses (including spaying and neutering if applicable) will be paid for by S’Wheat Rescues. If your foster dog is in need of veterinary care you must call S’Wheat Rescues and obtain approval before hand unless it is a life and death emergency for the dog. You will be responsible to make appointments as necessary and provide transportation for such visits. Do you agree to these responsibilities? Yes No
 
 
 
 
* Do you agree to get prior approval before incurring any Veterinary, Grooming or other expenses for a foster dog in your care? Yes No
 
* Do you understand and agree that expenses incurred without prior approval will not be reimbursed? Yes No
 
 

I hereby apply to be a foster parent for a Soft Coated Wheaten Terrier. I agree that this is a temporary arrangement and I will immediately relinquish any dog assigned to me immediately upon request. I accept responsibility for the dogs basic care and release the previous owner, as well as S’Wheat Rescues from any liability, save approved and emergency veterinary expenses concerning assigned dog.

CONFIDENTIALITY AGREEMENT: I do hereby state that I am in no way affiliated with any other Wheaten rescue, with anyone who is part of another Wheaten rescue or any other rescue. I agree to keep all information given to me regarding S’Wheat Rescues, it’s owners, other coordinators, foster homes, rescue dogs or any other proprietary information in total and complete confidence.

 
* Do you agree to these terms? Yes No
 
 
 
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