Response-O-Matic Form

 

Chicagoland German Shepherd Rescue

Just complete this form. Click on Submit ONCE when ready to send.
Please do not hit ENTER unless you are ready to send. Use TAB to go to the next line. Otherwise, your application will be sent incomplete. Thank you.

 

Chicagoland Shepherd Rescue Foster Application - Online


*note: Please fill in all fields. Where more than option is given, please check all that apply.

Thank you for expressing interest in being a foster home for one of our wonderful rescued german shepherds! the purpose of this application is to determine the appropriateness of your circumstances for being a foster home and to assist us in finding the most appropriate german shepherd for you to foster.


Date:

Personal Information:
Name:
Home Phone:
Address:
Work Phone:
City, State, Zip:
E-mail address:
Are you 18 years or older?:
yesno

Residence you live in?
House Apartment Condo Mobile Home Other (please explain) :

Type of area you live in?
Rural/Country SuburbanUrban/City



Do you:
ownrent
Name and phone # of landlord if you rent:

Does your lease have restrictions regarding animals?
yes no
Does your lease require a deposit for having animals?
yesno

Date of Birthr :

Employer:
Work Phone:
Occupation:
Typical Hours Worked: What time to what time?

Please list 3 references - 1 Business and 2 Personal references (none of which can be related to you or employed by you). Please contact your references and tell them to be expecting our e-mail reference request or telephone reference request. This section is mandatory. If you do not fill it out you will not be eligible to adopt from us.

Business Reference:
Name:
Work Phone :
HomePhone:
Email Address:

Personal Reference:
Name
Work Phone:
HomePhone:
E-mail Address:

Personal Reference:
Name:
Work Phone:
HomePhone:
E-mail Address:

When is a good time to call?:

General Information:
Why are you interested in becoming a foster home for a german shepherd dog?
How did you hear about Chicagoland Shepherd Rescue?

Have you previously been a foster home for any other oganizations?

if yes, which ones:

Please discuss any previous experience with dogs:


Please provide the following information about the people currently living in your household:
Number of adults:
Number of Children:
Ages of Children:
Who will have primary responsibility for the care of the dog?
How many hours per day will the dog be left alone?

Where will the dog be kept during the following times?
day:
night:
when you are not home:
What animals have you owned in the past 5 years?
Pet's Name:
Type/Breed:
Kept Where?:
Age:
Neutered/Spayed:
Male/Female:
Still Own?

Pet's Name:
Type/Breed:
Kept Where?:
Age:
Neutered/Spayed:
Male/Female:
Still Own?

Pet's Name:
Type/Breed:
Kept Where?:
Age:
Neutered/Spayed:
Male/Female:
Still Own?

Pet's Name:
Type/Breed:
Kept Where?:
Age:
Neutered/Spayed:
Male/Female:
Still Own?

Pet's Name:
Type/Breed:
Kept Where?:
Age:
Neutered/Spayed:
Male/Female:
Still Own?

Have all your dogs been housetrained?: yesno
If no, please explain:
What (if any), behavior problems do you have with your dogs:


Have you dogs ever bitten anyone? yesno
If yes, please describe:

What brand of food do you feed your dogs?
How often do you feed your dog(s)?

Do you have a veterinarian?
Yes
No
If Yes, please list the name of the clinic, the vetís name and telephone # :
If No, would you accept our reccomendation?Yes No

When were your dogs last tested for heartworm? (month/year)
Are your dogs current on heartworm preventitive medicine? daily monthly no

When were your dogs last vaccinated for:
Distemper/Parvo: date -
Rabies: date -
Bordatella: date -
Do any of your pets have any serious/ chronic health conditions?: yes no
if yes, please explain:
May we contact you to verify this information?: yes no

About the Dog:
What is it about the german shepherd breed that interests you?:

Please check the 3 most important characteristics you enjoy(ed) in the dogs that are (have been) in your life:
Active
Playful
Independent
Protective
Dominant
Intelligent
Loving
Calm
Aggressive
Submissive
Good with Kids
Good with Dogs
Good with Cats
Outgoing/ Friendly

Are there any characteristics that you are unwilling to work with?


Have you ever moved and not taken your pets with you?
no
yes if yes, please explain:


How do you discipline your dogs?


Have your dogs graduated from an obedience class? yes no
If Yes, please provide name and phone number of your trainer:
If No, why not?


What types of shepherds are you willing to foster? (check all that apply)
Females Males Adults Puppies Injured/ Sick Shepherds Abused/ Neglected Shepherds

Do you have a completely fenced in yard? yes no

If no, how do you plan on exercising your shepherd?

Describe the fence:
Height:
Type of fencing:
Number of gates:

Can people or children easily open the gates?
yesno
Do people or children have access to your yard when you are not home?
yesno

Where will your foster shepherd be kept when you are not home?:
Loose in the House Crated in the House Tied Outside in the Dog Run in the Garage Other
If chose Other, please specify:


Check how long the dog will be alone when you are not home:
Less than 3 hours 3 - 6 hours 6 - 9 hours 9 - 12 hours More than 12 hours
If the dog will be alone 6 or more hours per day, what arrangements will you make to allow the dog to relieve themselves?


Are you comfortable with:
Bathing dogs Grooming House Training Shy Dogs Stand Off-ish Dogs Active Dogs Clipping dogs nails Giving dog medications

Please check all that you own:
Dog Crate(s)
if so, what type? Plastic Wire Size
Nail Clippers Leash Collar
How many daily walks would you be able to provide for the shepherd? and the duration of the walk?
Are you able to drive distances to assist in picking up dogs?
Yes No
Have you ever been party to a civil suit? Yes No
If Yes, please describe:

Do you have any health problems which might affect your fostering ability? (e.g. cannot lift dog over 50lbs due to back problem)?


Any additional information or comments you would like to share with us?

Thank you so much for your interest in becoming a foster home for one of our beautiful rescued shepherds. We will review your application (including references) and follow up within two weeks of its reciept.

When the application is complete, please hit the Submit button only ONCE. If you need to start over, hit Reset.
Response-O-Matic Form

 

Chicagoland German Shepherd Rescue Foster Application