OUTCOME
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NOTE: Please only fill out this application if you are interested in fostering. If you are interested in fostering-to-adopt and/or your intention is to adopt a dog then 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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1. Today's Date:
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2. Desired Dog to foster:
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3. Name (First AND last name, please):
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4. Occupation:
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5. Address:
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6. 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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7. Zip:
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8. Home Phone:
9. Cell Phone:
10. Work Phone:
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11. Email:
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What age bracket do you fit in?
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
12. Name of Spouse/Partner at residence:
13. Spouce/Partner Occupation:
14. Other adults (21 or older) at residence. Please list name, age and relationship to you:
15. Chidren (under 21 years) at residence. Please list name, age and relationship to you:
16. Please describe children's experience with animals:
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17. Is anyone at your house allergic to dogs?
Yes
No
I don't know
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18. Who is home during the day; what hours/days?
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19. What would their responsibilities be with the dog?
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20. 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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21. Level of dog experience:
No experience- first time
Beginner
Intermediate
Expert
22. If "expert" please explain your answer
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Indicates Response Required