HART of IL Dog Rescue

HART Foster Application

Application will take 10-15 Minutes to Complete

Your Name First & Last

Your Email Address

Street Address

City, State Zip

Home Phone

Cell Phone

What Dog you want to foster

How did you hear about us

Your Occupation

Your Age

Co-Applicant First & Last Name

Co-Applicant Occupation

Co-Applicant Cell Phone

Co-Applicant Work Phone

Relationship to Applicant

Child # 1 in Home

Age

Allergic to pets?

yes
no

Child # 2 in Home

Age

Allergic to pets?

yes
no

Child # 3 in home

Age

Allergic to pets?

yes
no

Child #4 in home

Age

Allergic to pets?

yes
no

How long at current address?

Do you own or rent?

own
rent

Is this a

house
apartment
condo
duplex
modular
townhouse

If renting, Landlords name

Landlords Phone

Is there a pet deposit required?

yes
no

Approx size of your yard

Do you have a fence?

yes
no

If so, what kind

wood
chainlink

If no fence, describe how you will excersize your foster dog

Does your city have a limit on # of pets?

yes
no

City Animal Control Phone

Current Vet's Name

Current Vet's Phone

Name Vet records are under

Please list all pet's you have.

Type of pet, breed, gender, spayed or nuetered.

Can you bring the foster dog to adoption events?

yes
no

Can you bring your foster pet to vet appointments?

yes
no

What size dog do you prefer?

What age do you prefer?

Would you be willing to
foster a pet with special needs?

Reference #1 Name & Phone

(not a relative)

Reference #2 Name & Phone

(not a relative)

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READ BELOW BEFORE SUBMITTING

By clicking SUBMIT you are agree that you have filled out this application completly and honestly. You are also authorizing HART to do a home visit prior to dog being placed in your care and understand that rescue dogs need a longer transistion period. By clicking SUBMIT you are electronically signing our foster application and agreement.

Once application is submitted, please make a $10 Donation via PAYPAL to offset administrative cost. Follow the paypal link on the confirmation page after you've submitted your application.