Name *

Address City, State and Zip *

Best phone number to reach you at *

Work phone (with area code) *

Do you own you own your home or do you rent? *

If renting, does your landlord allow dogs? If not applicable type NA. *

Please describe property? *

Is your yard fenced? *

If your yard is fenced - what type of fencing material? *

Please check all that apply *

Do you have other adults living with you? *

If you have other adults living with you, please list their names below, one per line. If not applicable type NA. *

Do you have children living with you or do children visit your home regularly? *

If you have children living with your or that visit regularly, please list their names below, one per line. If not applicable please type NA. *

If you have children living with your or that visit regularly, are they trained to be around a dog? *

If you have children living with your or that visit regularly, how do they react to dogs? If not applicable, type NA. *

Is anyone in your home or who visits your home regularly allergic to dogs? *

Is anyone in your home or who visits your home regularly allergic to dogs? *

Would you consent to a home check upon request? *

What is your occupation? *

Employer name and address? *

Employer phone number? *

How long have you worked for this company? *

Would you be willing to provide references to verify employment if requested? *

What is the name and address of the veterinary clinic you use? *

What is the clinic's phone number? *

If you see a specific vet at this practice, what is their name? If not applicable type NA. *

The person/family agreeing to foster the Shiba will make no decisions or actions regarding the Shiba's vet care or placement without prior approval from SRNJ, Inc. In case of life-threatening emergency the foster family agrees to get immediate medical care, and contact a rescue representative as soon as possible. *

The foster family agrees to provide the Shiba with humane, loving care while the Shiba resides with them. The foster family also agrees to not allow the foster Shiba to come in contact with their own dogs nor be allowed to play, run, walk or sleep in the same areas as their own dogs. Foster Shiba is to be kept separate unless detailed agreements are set in place through a SRNJ Representative. *

The foster family agrees to provide the Shiba with a fully fenced yard or other approved means of exercise. The Shiba shall not be kept tethered or excessively outdoors, nor taken to dog parks. *

In the event the Shiba is lost or stolen, the foster family will contact the SRNJ Representative immediately and make all reasonable attempts to locate the Shiba. *

Medical expenses associated with fostering are reimbursed to the foster family by the rescue. These expenses are ALWAYS to be pre-approved by SRNJ, Inc. in advance (except in the case of a life-threatening emergency). *

If for any reason the foster family cannot continue to foster the Shiba in their care, they shall notify SRNJ immediately and alternative arrangements will be made as soon as possible. The foster family WILL NOT undertake locating another foster home of their own. *

All foster families must be pre-screened. In addition, the foster family understands that family, friends, co-workers and others interested in adoption must contact SRNJ, Inc. and follow appropriate procedures. Under NO circumstances may the foster family place the Shiba in any home that has not been approved by SRNJ, Inc. *

The foster family understands that SRNJ, Inc. has limited information regarding the temperament or habits of the Shiba in question. The foster family will take all reasonable precautions (through the use of leashes, supervision, fencing and common sense) to ensure that the Shiba does not run loose, become a nuisance, destroy property, cause injury to or become injured by another animal or by a person(s). *

The foster family agrees not to keep the Shiba confined to a crate, except for house training or sleeping. Some Shibas become unduly stressed when crated or have exhibited behavior problems because of excessive crating in the past. *

In the event the foster family wishes to adopt the Shiba in their foster care, they must contact the rescue volunteer in charge of this Shiba and make formal arrangements (this includes completing the adoption application and contract). *

The foster family agrees to immediately surrender custody of the foster Shiba to a SRNJ Representative upon demand. The foster family agrees that the foster family has no legal ownership and will not obtain any legal rights to the foster Shiba in their care. *

SRNJ, Inc. agrees not to place any rescue dog known to bit or destroy property with any family. If aggressive or destructive behavior becomes evident during the fostering period, SRNJ agrees to work out a date to remove said Shiba from foster home to another location when reasonable possible. *

The foster family does hereby release, discharge and hold harmless Shiba Rescue of New Jersey, Inc. and any of its officers for damages, loss of services, actions and causes of action, belonging to the said foster family for any action or occurrence, from the date of this agreement , arising out of, or in connection with, the fostering of any rescue dog. By entering today's date and your initials in the box below and submission of this form you note your agreement to this foster application's stipulations. *