All fields are required.

Contact Information

    1.  Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Day Phone
Night Phone
Cell Phone
E-mail

    2.  Best time to reach you:

1 2 3 4 5 6 7 8 9 10 11 12   AM PM

Living Conditions

   3.  What type of housing do you live in?

Apt/Condo
Townhouse
Single Family Home

    4.  Do you own or rent?

Own
Rent

    4a.  If you rent, does your landlord permit dogs?

Yes
No
Not Sure

    4b.  If you rent, is there a weight/size limit on allowable dogs?

Yes
No
Not Sure

    4c.  If yes, what is the weight/size limit?

    4d.  If you rent, please provide your landlord's name and contact information for verification of requirements:

Name
Work Phone
Home Phone
E-mail

    5.  Do you have stairs in your home?

Yes    No

    5a.  If yes, how many stairs?

    6.  Do you have a fenced in yard?

Yes    No

    6a.  If yes, please describe your fence:

    6b.  If no, do you agree to keep the foster on a leash when outdoors?

Yes    No

    7.  Are you willing to have a volunteer from GABR visit your home prior to fostering?

Yes    No

Dynamics of Household

    8.  What is the make-up of your household?

        Number of adults

        Number of children:

    8a.  If there are children in the household, what are their ages?

    9.  Are there other children who visit frequently (i.e. grandkids, babysitting)?

Yes    No

    9a.  If yes, what are the visiting children's ages?

    10.  Please list the pets you currently own and provide the information requested on each one.

						Date of Last			Date of Last
	Dog (List Breed),		Time Owned		Spay/Neuter	Inoculations For…			Heartworm
Pet’s Name	Cat, Bird, Other	Age	(Yr./Mos.)	M/F	(Yes/No)	Rabies	DHLPP	Bordatella	Test
				----Please Select---- Male Female	Yes No
				----Please Select---- Male Female	Yes No
				----Please Select---- Male Female	Yes No
				----Please Select---- Male Female	Yes No
				----Please Select---- Male Female	Yes No
				----Please Select---- Male Female	Yes No

    11.  Describe the temperament of the dog(s) you currently own.

Dominant
Submissive

    12.  Describe the activity level of the dog(s) you currently own.

Docile
Active

    13.  Do you give Heartworm preventative to your dog(s) on a monthly basis?

Yes No

Veterinarian Information

    14.  Do you have a veterinarian?

Yes No

    14a.  If yes, please provide your veterinarian's name and phone number.

Name
Organization
Work Phone
FAX
URL

15.  What pet name and last name are your current vet records under?

Fostering and Care of Your Foster

    16.  Why do you want to foster a Basset?

    17.  How do other family members feel about fostering a Basset?

    18.  Which family member will be the foster's primary caregiver?

    19.  How many hours per day will the foster be left alone?

    20.  Where will the foster be kept during the day?

    21.  Where will the foster be kept during the night?

    22.  Are you willing to take your foster to a veterinarian on GABR's approved list?

Yes No

    23.  What is the brand name of the dog food you will be feeding your foster?

Experience and Foster Type

    24.  Have you ever owned a Basset?

Yes No

    25.  Have you ever adopted a dog from a rescue organization or shelter?

Yes No

    26.  Have you ever fostered for a rescue organization before?

Yes No

    26a.  If yes, please explain:

    27.  Have you ever had to give up a dog?

Yes No

    27a.  If yes, please explain:

    28.  Are you willing to foster a special needs or senior Basset?

Yes No

    29.  Are you willing to foster a Basset recovering from surgery and/or on medication?

Yes No

    30.  Are you willing to foster a Basset being treated for heartworms?

Yes No

    31.  Are you willing to foster more than one Basset at a time?

Yes No

Training Your Foster

   32.  Have you ever taken a dog to obedience training?

Yes No

    33.  Are you willing to house train your foster, if necessary?

Yes No

    34.  Are you willing to crate train your foster?

Yes No

    35.  Do you have an available crate for your foster?

Yes No

    35a.  What size is your crate?

Your availability and Ability to Submit Information About Your Foster

    36.  Are you available by e-mail on a daily basis?

Yes No

    37.  Do you have an answering machine that you check every day?

Yes No

    38.  Do you own a working digital camera?

Yes No

Thank you for your interest in fostering a Basset Hound for Guardian Angel Basset Rescue!!!!!!!!!