Name

Email   

Address 1

Address 2

City   State   Zip

Home phone     Work phone

Why are you interested in Dalmatians?

Tell me about your family life. Is your family active? Do you enjoy going out to parks, taking walks, do you have family visitors to the home on a regular basis?

How many people live in your home:  

# of children in home:     Ages of children:

Who will help in the care of the foster Dalmatian?

What is your background & experience with training and behavior:

Have you ever taken a dog to obedience training?   Yes  No

Explain what training methods you have used:

Have you had experience with, lived with Dalmatians in the past/present?

Does anyone in your home have an allergy to dogs?

This Dalmatian would be alone for per a day.

I live in a     House Condo Apartment Mobile Home Other

Own   Rent   Lease

Landlord's Name

Landlord's Address

Landlord's Phone

Do you have a fenced yard ?  Yes  No

If you have a fenced yard, please check all that apply: Under 4 ft.    4 foot    5 foot    6 foot or higher    Chain link    Picket    Invisible    Privacy    Other

Approximate size of fenced area

During the day, the Dalmatian would be, please check all that apply: Loose indoors    Crate    Basement    Garage    Loose outdoors    Tied up outside    Kennel run    Other

At night, the Dalmatian would be, please check all that apply: Loose indoors    Crate    Basement    Garage    Loose outdoors    Tied up outside    Kennel run    In bed with owner    Other

What other dogs have you owned in the past? (Breed, Sex, Age, Spayed/Neutered)

Breed age sex   neutered/spayed ? Yes No

Breed age sex   neutered/spayed ? Yes No

Breed age sex   neutered/spayed ? Yes No

Breed age sex   neutered/spayed ? Yes No

Breed age sex   neutered/spayed ? Yes No

Breed age sex   neutered/spayed ? Yes No

If a dog that you have had in the past is no longer with you what happened to the dog?

Name and phone number of your current or last veterinarian:

Do we have your permission to contact your vet?     Yes    No

How many dogs are currently in the home, ages, sex, how are they around other dogs?

What other animals are in the home?

Are all the animals in your home spayed or neutered?     Yes    No

Who will care for the day should you go away for a couple of days?

Have you owned this breed before?     Yes    No

Do you realize that Dalmatians shed, can be quite active, are inside dogs, need to be with the family, can have kidney stones, and can be deaf?    Yes   No

Are you aware that when you foster a Dalmatian, you are taking on a responsibility that may range from just a few days to several months?   Yes   No

Specific preferences for fostered animals:
Sex: Male   Female
Age: Under 1  1 to 3 years   3 to 5 years   5 to 7 years  8 and older

Please provide us with names and phone numbers of 3 personal non related references.

I AGREE THAT I HAVE NOT NOR HAS ANY OTHER PERSON LIVING IN OUR HOUSEHOLD, BEEN CHARGED WITH ANY FORM OF ANIMAL ABUSE, NEGLECT OR CRUELTY? (EVEN IF THE CHARGES WERE LATER DROPPED OR FOUND GUILTY).
Agree   Disagree

ARE YOU WILLING TO PROVIDE WEEKLY UPDATES ON THE DOG?
Yes    No

WE PROCESS THE APPLICATION JUST LIKE WE WOULD AN ADOPTION. WE WILL DO A HOME VISIT, REFERENCE AND VET CHECK. WILL YOU ALLOW AN AAS REPRESENTATIVE TO DO A HOME VISIT?
Yes    No

Please Read: As a foster care provider, I agree to follow the Adopt A Spot Guidelines in this agreement. The fostering period can last from a few days to a few months depending on the adoptability and health of the dog.

I will provide each rescue dog with comfortable, clean, indoor housing, a premium food diet and have fresh water available at all times. I agree to keep any rescued Dal in a secured, fenced environment or on a leash at all times. This Dal will sleep inside the home. Furthermore, I agree to never use electronic training devices or invisible fencing with a rescued Dal. I will also teach the Dal proper behavior and housebreaking, if needed, while in my care. I will try to socialize the dog as much as possible to make it a welcomed addition to anyone’s home.

Dalmatians are typically affectionate and friendly and Rescue will not place a dog known to have an unsound temperament. However, no one can predict how any dog will react in a given situation, especially without complete knowledge of its life experiences. Therefore, foster homes are strongly urged to exercise prudence and caution in introducing an adoptive dog into a new situation until the Dalmatian has become fully adjusted to its new environment and the foster family has had an opportunity to become familiar with this Dalmatian’s unique personality. Adequate time must be given for the dog to fit into your household. AAS will provide background information on the foster animal.

I understand the Rescue makes no representation, warranty or guarantee as to the health or disposition of any animal because Rescue is uncertain of its background. Rescue does inquire of known owners as to whether the animal bites, however, Rescue makes no representation, guarantee or warranty that the animal does not bite.

I understand by signing this form, I agree to release and covenant to hold harmless Adopt A Spot Dalmatian Rescue and it’s members from any claims, damages, costs or actions incurred as a result of the foster care or actions of the foster animal.

Veterinary care, such as, but not limited to vaccinations, heartworm testing, heartworm preventative, fecal test, spay/neuter, will be reimbursed to foster home by Adopt A Spot. All such expenses (except for emergency situations) must be APPROVED IN ADVANCE by an Adopt A Spot representative.

Receipts for approved expenses and/or emergency veterinary visits must be submitted for reimbursement. They must be sent to: Adopt A Spot Dalmatian Rescue P.O. Box 9375 Chesapeake, VA 23321. Unapproved expenses will not be reimbursed. You must seek veterinary care from the office or clinic that is advised/approved by an Adopt A Spot representative.

If there is any change in the dog’s health, personality or eating habits, please contact an Adopt A Spot representative immediately. If the dog becomes ill or die, I will contact Adopt A Spot Dalmatian Rescue immediately.

I cannot adopt the dog out on my own and will send all inquiries to an Adopt A Spot representative. If I decide to keep the dog, I will notify an Adopt A Spot representative immediately or within 2 weeks from placing the Dal into your home. I will have to follow the proper adoption proceedings and will be subject to the standard adoption fee.

I will notify Adopt A Spot immediately if this dog is lost or stolen and will make all reasonable efforts to locate the dog. The foster dog will wear an ID tag at all times, which is provided by rescue.

I, agree to all the above terms and conditions and understand that Adopt A Spot will retain ownership of any dog I foster for them until adopted.

Agree Don't agree

Thank you for taking the time to fill out this questionnaire. By pressing the SUBMIT button, you attest that all of the information you have provided in this application is true and correct. You also are certifying that you understand and agree with these requirements. Please only click the submit button once.