Foster Application Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Home Phone*Work PhoneEmail* Cell PhoneEmail* Enter Email Confirm Email How old are you?*What is your occupation?How many adults 21 and over live in your home? Who are they in relation to you?*How many individuals under the age of 21 live in your home? What are their ages?*Does anyone in your household have a fear of dogs?*Do you own or rent your home?*OwnRentIf you rent, have you received approval from your landlord to have an animal?*If you rent, please provide your landlord's name and contact information.*What type of home do you live in?*Single FamilyDuplexApartmentTownhouseCondoMobile HomeDescribe your home's activity level: busy/noisy, Moderate comings/going, quiet with occasional guests?*Please describe what the dog's living situation will be?*How many hours a day will he/she be home alone?*Where will the dog be kept when you are not at home? (Example: crate, pen, outside kennel, free roam in house, gated off area/room)*How will you exercise the dog?*Where will the dog sleep at night?*How will the dog be cared for during overnight absences or while on vacation?*What type of setting is your home in?*RuralSuburbanCityWhat is the size of your yard?*SmallMediumLargeIs your yard fenced?*No YardUnfenced YardYard Partially FencedYard Completely FencedWhat type of fence?*No FenceChain LinkPrivacyInvisible FenceDo you have other dogs in your home? If so, please provide the breed, gender, age, spayed/neutered, and if shots are up to date.*Have your current pets been exposed to or are tolerable of other animals?*If you have had other dogs in the past, please let us know their current whereabouts and details. (Example: I still have, died of old age/sickness, given away, hit by a car, disappeared/lost, turned in to the shelter)*Do you have any other animals in your home? If so please list.*Who will be the main caregiver?*How would you address undesirable behaviors?*What are your thoughts and views on training?*Are you willing to take the dog to training?*YesNoWill you be able to take the dog to vet appointments, monthly QCP events and allow potential adopters to visit the animal?*Will you be able to medicate an animal if necessary, even if it is only monthly heartworm or flea prevention pills?*Why are you considering this specific breed of dog or this organization?*Do you have experience with this breed? If so, please explain.*What will you do if the dog soils the floor or claws/chews the furniture?*What will you do if the dog gets into trouble by ruining something of value?*What types of behaviors do you consider Unacceptable?*In your opinion, what physical symptoms and/or behaviors would warrant immediate medical attention?*How will you discipline the dog?*What would you do if you could not keep your foster?*What circumstances, in your opinion, justify giving up your foster? (ie. barking, housebreaking, chewing, jumping up, shyness/other fears, shedding, digging, etc)*Have you ever given up a pet? If so, please explain?Please list the name and phone number for your current veterinarian. Please also give QCP permission to speak to your vet.*Please list TWO references that are not family members.*Do you have a vacation scheduled within the next two months? If so, please explain.*Are you currently fostering for any other organizations? If so, please include organization name and contact information.*How did you hear about QCP?*Is there any other information that you'd like us to know about you?*I certify that the information entered on this application is true.*Enter your name and date. NameThis field is for validation purposes and should be left unchanged.