OUTCOME
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NOTE: Please only fill out this application if you are interested in fostering. If your intention is to adopt a dog or if you are interested in fostering-to-adopt, please fill out our adoption application!
Applicant must be at least 21 years old
Applicant must live in the Los Angeles Area
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Today's Date:
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Is there a particular dog that we have now that you want to foster? If so, please tell us his/her name:
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First Name
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Last Name
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Address:
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City:
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State:
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
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Zip:
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Home Phone:
Cell Phone:
Work Phone:
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Email:
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1. What is your occupation:
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2. What is your age range?
Under 21 years old
21-25 years old
26-30 years old
31-35 years old
36-40 years old
41-45 years old
46-50 years old
51-55 years old
56-60 years old
61-65 years old
66-70 years old
71-75 years old
76-80 years old
81-85 years old
Over 85 years old
3. Name of Spouse/Partner at residence:
4. Spouce/Partner Occupation:
5. What is your spouse/partner's age range?
Under 21 years old
21-25 years old
26-30 years old
31-35 years old
36-40 years old
41-45 years old
46-50 years old
51-55 years old
56-60 years old
61-65 years old
66-70 years old
71-75 years old
76-80 years old
81-85 years old
Over 85 years old
6. Other adults (21 or older) at residence. Please list name, age and relationship to you:
7. Chidren (under 21 years) at residence. Please list name, age and relationship to you:
8. If you have children please describe children's experience with animals:
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9. Is anyone at your house allergic to dogs?
Yes
No
I don't know
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10. Who is home during the day (you, other family member, housekeeper, etc.) - what hours/days?
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11. If the person home during the day is NOT you, what would their responsibilities be with the dog?
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12. Will the other household occupants be able to accompany you when you come to meet the dog(s)?
Yes
No
I am the only occupant
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13. Level of dog experience:
No experience- first time
Beginner
Intermediate
Expert
14. If "expert" please explain your answer
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Indicates Response Required