Name of the foster dog you wish to adopt

Breed or description of dog you wish to adopt

Your Contact Information

First Name   Last Name

Address        City    State    Zip

Telephone Number    Additional phone number

When is the best time to call you?   No more than 3 attempts will be made to call you.

Email Address

Your Family Information

Number of Adults in Household    

Number of Children under 18 who live in Household

While many dogs very much enjoy children, some dogs should not be with small children, due to behavior, health or a delicate build. When telling us about the children in your household, please let us know if there will be children who visit often, such as grandchildren. Children's visiting friends don't need to be included.

Number of visiting children under 18, such as grandchildren, nephews, etc. 

Ages of children in household 

We intend for this pet to be a member of your home. It is important that everyone in your house is in agreement that this pet is wanted. This includes your spouse, children who are living at home, a full time babysitter who provides care in your home, or anyone who will be responsible for caring for this dog on a day to day basis.

 Are all members in the household, including spouses, children, and babysitters, aware that you plan to adopt a dog?  

Is anyone in your home allergic to animals?

About your home

Do you reside in House Apartment Other

Do you  Own Rent

Renters: Your landlord will be contacted prior to adoption. Failure to submit landlord information will disqualify you.

If renting, what is your landlord's policy concerning pets?

Name of Landlord Address

City State   Zip   Telephone Number

Your Animal Experience

Do you currently have other animal(s)?  Yes No

If yes, please list type of other animal(s).

Age of pets   Are they spayed/neutered?  Yes No

How many pets have you owned over the last five years? 

If they are no longer with you, please state the reason. A reason must be given for each pet.   

What will your schedule be for exercising this dog? 

Where will this dog sleep in your home? 

Where will this dog be kept while you are away from home (such as: on vacation)?

Is your yard securely fenced on all sides?  If so, what type of fence?   

References

We will contact your veterinarian to verify your animal's vaccination status and health care.                                                                                                                      Please inform your vet that we will be calling in order that records can be shared with us.                                                                                                                            If you have no current veterinarian, please list your most recent vet, no matter how long ago.                                                                                                                         Please provide the name(s) those records will be listed under if different from above.      

Name of current/past veterinarian    

Address of current/past veterinarian  

Telephone Number                           

Name of a reference we can contact 

Telephone number                            

If you use a certain groomer, please list name and phone number here 

Most of our foster dogs come to us as strays, and are in need of obedience classes. Where will you take them for training?

Why do you want to adopt this pet? What makes you the best home we can find for this animal?

How did you learn about Foster Pet Outreach? (newspaper, friend, website, etc)

Please note:

(1) We reserve the right to visit the home where the cat will live prior to adoption.                                                                                                                                       (2) We reserve the right to approve or deny any adoption for any reason and the right to not disclose the reason.                                                                                       (3) You must be at least 18 to apply.                                                                                                                                                                                                       (4) Foster Pet Outreach prefers to limit our adoptions to an area within approximately 60 miles of Peoria, Illinois so we can keep our promise to return the pet to our foster care program if the adoption is not successful. Out of State adoptions are out of the question.