Dog Foster Application

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Default Status
First Name*
Last Name*
Age Range*
eMail Address*
eMail Address Confirm eMail Address
Country
Street Address
Suite | Apt or Unit Number
City
State/Province
ZIP
Mexican Address*
Street Address Neighborhood City State Postal Code
Canadian Address*
Street Address Neighborhood City Province Postal Code
Cell Phone Number*
Preferred Method of Contact
Employment & Schooling
Are You Employed?*
- Yes
- No
- Retired
How Did You Hear About Us?*

Would You Consider:
Select all that apply.
A Mixed Breed Dog*
A Pregnant Dog*
Fostering Bottle Babies*
Two Dogs*
A Dog That Can Be An Only Pet?*
A Dog That Is Afraid Of Small Children*
- A Dog That Needs Medications?*
- A Dog That Has a Serious Health Condition?*
- Please Select All Health Condition(s) You Would Accept:*
- A Dog Who Needs Training For A Behavior Issue?*
- Please Select All Behavior Issue(s) You Would Accept*
- A Dog That Has Special Needs?
- Please Select All Special Needs(s) You Would Accept:*
  Select All That Apply
A Dog That is Not Completely Housebroken?*
Select Gender*
Select Age Range*
Select All That Apply
Select Temperament*
Select All That Apply
Do You Have A Preferred Dog?
List Other Dogs You Are Interested In
When Will You Be Ready To Foster?*
Is There Anything Else You Would Like to Let Us Know?
I am interested in receiving pet related services and products
- Yes
- No
Authorization
Authorization:*
All dogs placed through the Cortez Rescue will have health checks, personality and temperament evaluations, and will be spayed or neutered prior to placement unless a medical condition exists, diagnosed by a veterinarian, that would prevent this surgery. I understand that this is a preliminary application and that there may be no Dog available in rescue at this time. I understand that if a Dog should become available, that I will be required to provide further information including, but not limited to, personal and veterinary references. I further understand that all information on my Preliminary Rescue Foster Application will be kept confidential; that my application will be kept on file until I notify the Cortez Rescue that I am no longer interested in a rescue; and that I will not be contacted unless an appropriate Dog becomes available. I understand and agree *
- I agree
Comments
This field is for validation purposes and should be left unchanged.

Dog Foster Application

Foster

Employment & Schooling

Yard Information

Feeding & Exercise

Behavior & Training

Foster Care

Would You Consider:

Authorization

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