FOSTER HOME APPLICATION
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I am interested in becoming a:	Regular Foster Permanent foster for a special needs dog Emergency foster for holidays and short term needs only
CONTACT INFORMATION
*First Name of Applicant:
*Last Name of Applicant:
Name of Co-Applicant:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Cell Phone:
*Email Address:
HOME INFORMATION
Applicant Occupation:
Employer Name:
Work Schedule:
Co-Applicant Occupation:
Co-Applicant Employer Name:
Co-Applicant Work Schedule:
How long have you lived at current address?
If less than a year, please provide previous address.
Do you live in a:	House? Apt.? Duplex? Condo? Other?
Do you:	Own Rent
If you rent, provide name of complex, landlord’s name, and phone number.
Do you have a fence?	Yes No
Adopt A Golden Atlanta, Inc. requires a fenced in yard for all homes with children 6 years old and under. Invisible fencing is acceptable for some dogs and not for others. The Adopt A Golden Atlanta Board of Directors reserves the right to decline placement of a dog who is not a good candidate for an invisible fence into a home with such fencing. The only acceptable invisible fencing is the Invisible Fence brand by Pet Safe - http://www.invisiblefence.com and Dog Watch Hidden Fence brand - http://www.dogwatch.com. In addition, the Adopt A Golden Atlanta Board of Directors reserves the right to require standard fencing for certain dogs in the program (puppy mill dogs, strays for example), regardless of whether there are children in the home or not.
If yes, what type of fence?
Height of fence?
If no, do you plan to install one?	Yes No
If you do not have a fence and do not plan on installing one, how will you handle outdoor time?
Do you have a pool?	Yes No
Do you have water access (lake house, beach house, or boat)?	Yes No
How do you plan to exercise the dog?
Do you have a home computer:	YesNo
Do you have a printer:	YesNo
FAMILY INFORMATION
Please list any other adults living in household:
Please list names and ages of ANY children who live with you or visit you on a regular basis (include any grandchildren or other relatives)
Is any member of your household physically, mentally or emotionally challenged? If yes, please explain:
PET INFORMATION
List names, ages, spay/neuter status, species (dog, cat, etc.), and breed of ALL pets in your household:
Please provide a history of any dog ever owned:
Are ALL pets in your household up to date on vaccines, including bordatella?	YesNo
If no, explain:
How does your dog(s) react to other dogs (friendly, submissive, growls, etc):
What is the name, phone number and address of your current vet or the previous vet you used?
Have you ever cared for a dog being treated for heartworms?	YesNo
Have you or anyone in your family or living in your household, ever had an animal control violation or been convicted of an animal-related crime?	Yes No
If yes, please explain:
If you ever had a pet die at an early age or due to an accident, please provide details:
ADOPTION INFORMATION
Who will care for, exercise and train the foster dog?
How many hours a day will the dog stay alone:
Where will the dog stay when you are away from home during the day?
Where will the dog be kept at night:
Have you crate trained a dog before?	YesNo
Have you ever used a crate:	YesNo
If yes, under what circumstances and for how long each day:
Do you have a crate available for use with your foster dog	Yes No
Will your foster dog:	Have the run of the house? Be crated? Live in the basement?
When outside will your foster dog:	Stay in a run? Be tied out? Have run of the yard? Be on a leash?
Have you ever taken an obedience course with a dog:	YesNo
Is your own dog obedience trained:	YesNo
Are you willing to work with your foster dog in areas such as house training, basic obedience commands such as "come, sit, stay, down, off", and walking on a leash:	YesNo
Have you had experience in introducing dogs into your household:	YesNo
How do you handle thunderphobia?
Are you willing to supervise any children around your foster dog at ALL times:	YesNo
Please describe the type(s) of foster dogs you are willing to have in your home i.e. puppies, female, male, senior, special needs (examples being dogs that are recuperating from surgery, blind, deaf):
How many dogs are you willing to foster at one time: (occasionally there may be one or more dogs turned in at the same time that we will try to place together.)
Is there a preferred activity level for a dog you would want to foster:
How comfortable are you with giving medical treatment to a dog?
Have you ever fostered a dog before:	YesNo
If yes, for what organization:
Are you presently fostering for or volunteering with any other animal rescue organization:	Yes No
If yes, for what organization:
Do you intend on adopting from AGA in the immediate future	YesNo
How did you hear about us?	AGA newsletter AGA email blast AGA volunteer (please give name and telephone number below) Facebook or other social media Another Rescue Organization Other (please explain below)
How did you hear about fostering for AGA?	AGA newsletter AGA email blast AGA volunteer (please give name and telephone number below) Facebook or other social media Another Rescue Organization Other (please explain below)
Finally, please tell us why you would want to be a foster for a golden retriever:
I/we acknowledge that all the information provided is true and correct and that I/we have answered all questions truthfully. Submission of application does not guarantee placement of a foster dog through Adopt A Golden Atlanta, Inc. Reset