Mary T's Chi's Foster/Volunteer Application
Foster Application (last updated 07/10/18)
Full Name *
Your answer
Occupation *
Your answer
Address *
Your answer
How long at this address? *
Your answer
Phone *
Your answer
Best time to call *
Your answer
Email address *
Your answer
Family & Housing:
Fenced in yard? (What type)
Your answer
How many adults are in your family? (& relationship to you) *
Your answer
How many children (ages)? *
Your answer
What type of home do you live in (single family, town home, apartment, farm, etc.?) *
Your answer
Please describe your household: *
IF you rent please give rules regarding pets and the landlords name and number:
Your answer
*NOTE* Regarding above by providing this information you are allowing MTC to contact your landlord, please inform them of this call so they will speak with us.
Does anyone in the family have a known allergy to dogs? *
Your answer
Do you have time to provide adequate love and attention? *
Your answer
Other Pets:
What other pets do you have (specify type and number)? *
Your answer
Are these pets up to date on vaccines?
Your answer
Are these pets spayed/neutered? If not, Why?
Your answer
Have you ever lost a pet to an accident? *
Your answer
How did you hear about us? Referral? *
Your answer
Veterinarian:
Do you have a regular veterinarian? *
Veterinarians name:
Your answer
Clinic name:
Your answer
Clinic address:
Your answer
Clinic phone
Your answer
*NOTE* Regarding above.. By providing this information you are allowing MTC to contact your veterinarian. Please call your vet and ask them to authorize the release of information to MTC.
What is your idea of an ideal dog & why? *
Your answer
Desired age: *
Your answer
Desired size: *
Your answer
Desired dog (please put name of dog you're interested in.) *
Your answer
Desired sex: *
Where will the dog spend their day? (Describe) *
Your answer
Where will the dog spend the night? (Describe) *
Your answer
Number of hours (average) dog will spend alone? *
Your answer
Who will have primary responsibility of the dogs daily care? *
Your answer
Do you agree to provide regular health care by a licensed veterinarian? *
Do you agree to keep the dog as an indoor dog? *
When the dog goes out, how do you plan to supervise it? Fenced yard? *
Your answer
Do you agree to contact MTC if you can no longer keep this dog? *
Are you willing to let an MTC representative visit your home by appointment? *
Would you be interested in adopting? *
Personal References
Please list someone who is familiar with both you and your pets.
Ref #1 Name, address, phone, relationship *
Your answer
Ref #2 Name, address, phone, relationship *
Your answer
All the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed veterinarian. Type name below for electronic signature. *
Your answer
Date: *
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The foster shall not rehome the dog. If they decide to no longer foster the dog for whatever reason, the dog will be returned to MTC.
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