HOME - Mostly Mutts AR

MOSTLY MUTTS FOSTERING APPLICATION

First Name: (*)

Enter your first name

Last Name: (*)

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Your Age: (*)

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Street Address: (*)

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City: (*)

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State: (*)

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Zip Code: (*)

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Phone Number (Home):

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Phone Number (Cell):

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Email:(*)

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I am interested in fostering:(*)

DogsCatsDogs and cats Invalid Input

How did you hear about Mostly Mutts?(*)

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Have you previously adopted from Mostly Mutts?(*)

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Tell us a little about why you'd like to become a foster home:

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Do you own or rent?(*)

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Who pays the mortgage or rent?(*)

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If someone other than yourself pays the mortgage or rent, give that person's name and contact info:

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If you live in a rented accommodation, give the name and contact info for the landlord or rental agency or apartment complex:

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Number of adults in home, including self: (*)

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List adults by name (other than self) along with relationship to you and phone number:

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Number of children in home:

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Ages of children in home:

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Are other children regular visitors?(*)

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Work and Home:(*)

I work outside the home full time

I work outside the home part time

I am in college

I am at home most of the time (work from home/homemaker/retired)

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How many hours, per day, on average, will your foster dog or cat be left unattended?(*)

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If you work outside the home full time but your foster animals would be left home alone for only a few hours at a time, please explain:

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Place of employment:(*)

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How long have you worked there?(*)

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Have you ever surrendered an animal to a shelter or animal control or given a pet away?(*)

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If yes, please give details:

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How many dogs do you currently own?

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How many cats do you currently own?

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What other animals do you own?

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Are there any pets, other than your own, in the home?(*)

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If yes, please give details:

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Are your animals currently spayed/neutered?(*)

YesNoSomeNot Applicable Invalid Input

Are your pets up to date on vaccinations?(*)

YesNoSomeNot Applicable Invalid Input

We recommend all pets at home be up to date on vaccinations prior to fostering.

Are your animals currently on heartworm preventative?(*)

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We recommend all pets be on regular heartworm prevention.

List ALL dogs and ALL cats you currently own. List their names, breeds, genders, ages, number of years owned:(*)

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If all vet and vaccination records for your pets are at one single vet office and under one owner name: List that Vet Office Name, Phone Number and the Pet OWNER Name on the account:

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If the vet and vaccination records for your pets are at multiple vet offices or vaccination clinics: List each pet by name along with the Name and Phone Number of the Vet Office or Vaccination Clinic holding the latest records for that pet, and the OWNER Name on each account:

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Is your yard fenced?(*)

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If your yard is fenced, how high and what type of fencing?

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Do you have an electric or underground fence?

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Where will your foster dog stay during the day? (be specific):(*)

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Where will your foster dog sleep at night? (be specific):(*)

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How do you plan on exercising your foster dog?(*)

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How much time are you willing to give your foster dog to adjust to its new home/family?(*)

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PERSONAL REFERENCES - ALL APPLICANTS:

** Unless requested, references cannot be family members, roommates or landlords **

First reference name:(*)

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Relationship:(*)

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Best contact #:(*)

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Second reference name:(*)

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Relationship:(*)

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Best contact #:(*)

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PLEASE READ BOTH SECTIONS BELOW AND SIGN

Mostly Mutts appreciates your patience and understanding throughout this application process. Please understand our goal is to make sure these animals are placed in the best possible homes. The responsibility of Mostly Mutts is the best interest of the animal. The information I supplied in this application is accurate. Mostly Mutts has permission to contact my vet, landlord & references during the application process. Mostly Mutts has the right to refuse an application for any reason. This application remains the property of Mostly Mutts. All foster animals remain the property of Mostly Mutts and will be immediately returned to Mostly Mutts upon request. This application, when approved, does not constitute an agreement for adoption of any Mostly Mutts animal. A fully executed adoption contract is required for adoption placement.

I AGREE TO THE ABOVE SECTION(*)

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Mostly Mutts Volunteer Waiver of Liability Form
(Foster Families)

I desire to provide Volunteer services for Mostly Mutts Animal Rescue and Adoption, Inc., and engage in activities related to serving as a Volunteer. Mostly Mutts Animal Rescue and Adoption, Inc., (Mostly Mutts), is a non-profit corporation organized and existing under the laws of the State of Georgia.

I understand that the scope of a Volunteer relationship with Mostly Mutts is limited to a Volunteer position and that no compensation is expected in return for services provided by me.

I understand that the Volunteer services I provide to Mostly Mutts may include activities that may be hazardous to me, my family, my guests, my animals, including, but not limited to, bites, injuries, illness, death, and damage to personal property. My Volunteer activities may include, but may not be limited to, fostering of and caring for Mostly Mutts animals at my home and handling Mostly Mutts dogs on excursions and day-trips. As a Volunteer, I hereby expressly assume the risk of injury or harm from these and other Volunteer activities and Release Mostly Mutts from all liability for injury, illness, death or property damage resulting from the services I provide as a Volunteer.

I Release and forever discharge and hold harmless Mostly Mutts, and each of its directors, officers, employees and agents from any and all liability, claims and demands of whatever kind or nature which arise or may hereafter arise from the Volunteer services I provide to Mostly Mutts.

I understand and acknowledge that this Release discharges Mostly Mutts from any liability or claim that I may have against Mostly Mutts with respect to injury to persons or animals, illness of persons or animals, death of persons or animals, or property damage that may result from the Volunteer services I provide to Mostly Mutts.

I understand that Mostly Mutts does not assume any responsibility for or obligation to provide financial or other assistance of any nature in the event of injury, illness, death to myself, my family, my guests, my animals or damage to my property.

I expressly waive any claim for compensation or liability on the part of Mostly Mutts beyond what may be offered freely by Mostly Mutts.

By signing below, I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily. My signature, whether original or by electronic means, is valid as if it were an original signature.

I AGREE TO THE ABOVE SECTION(*)

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FULL LEGAL NAME:(*)

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APPLICANT SIGNATURE:(*)

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DATE:(*)

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