TLC Rescue PA

Foster Application

Applicant Information
Applicant Name *
Address *
City State Zip *
,
Email *
Date of Birth *
Home Phone *
Cell Phone
Current Employer *
Work Phone
Emergency Contact Information
Name
*
Phone #
*
Relationship
*
Household Members

Pet History (all dogs or cats owned in the last 10 yrs)

Household Information
Do any members of your household have allergies to dogs?
*
Have all the dogs and cats listed above been spayed or neutered?
*
Have all the dogs and cats listed above been kept up to date on vaccinations?
*
Have you ever rehomed, surrendered or returned a pet?
*
What type of home do you live in?
*
Do you own this home?
*
Landlord or Homeowner Name
*
Landlord or Homeowner Phone Number
*
Do you have a fenced in yard?
*
Fence Height (in feet, please provide a numeric response such as 4, 5, 6 below)
* ft
What is the fence constructed of?
*
How long have you lived in this home? (please provide a numeric response such as 0.5, 1, 3, 10 for number of years below)
Would you allow us to visit your home prior to finalizing your application?
*
Personal References

Name
*
Phone Number
*
Relationship
*
Name
*
Phone Number
*
Relationship
*
Veterinary References

The Fine Print

I certify that all information provided in this application is true and correct. I understand that any statements, representations or failure to disclose pertinent information will be considered sufficient cause for disqualification from consideration for volunteer and/or foster service or immediate discharge.

I acknowledge my position at To Love a Canine Rescue, Inc., is entirely voluntary and without compensation. I also understand that nothing contained in this application or in the subsequent interview is to create an expressed or implied volunteer contract between To Love a Canine Rescue, Inc., and myself. No promises regarding volunteer work or any duration of service have been made to me and I understand that no such promise is binding unless issued by To Love a Canine Rescue, Inc., in writing. I further understand and agree that if I am offered and accept a volunteer position at To Love a Canine Rescue, Inc., my volunteering can be terminated with or without cause, or with or without notice, at any time, at the discretion of To Love a Canine Rescue, Inc. I acknowledge and agree that my volunteer position is also contingent upon my signing the To Love a Canine Rescue, Inc., Volunteer Form and Waiver of Liability.

Date: 08/17/2017