KEI Foster/Adopter Application Form

PLEASE NOTE: K9 Enrichment Initiative (KEI) is an all volunteer organization and applications are processed in the order in which they are received. Please allow a minimum of 72 hours after submitting your application for a reply from our placement coordinator.

PLEASE COMPLETE ALL OF INFORMATION ON THIS FORM, IT IS REQUIRED FOR US TO PROCESS YOUR REQUEST TO BE CONSIDERED TO ADOPT ONE OF OUR DOGS. DELAYS OCCUR WHEN INFORMATION IS MISSING. APPLICATIONS NOT COMPLETED CAN BE DISCARDED.

Email address *

Today's Date *

YYYY

If you use Facebook, what is your Facebook name? *

Your answer

Applicants Birthdate *

Your answer

Name of Applicant *

Your answer

In running a background check is there another name your data is associated with in the system. Example: recently married, divorced *

Your answer

Driver's License # and Issuing State *

Your answer

Street Address, City, State, Zip Code (Please be sure to list COMPLETE address including City, State and Zip Code) *

Your answer

Co-Applicant Name

Your answer

In running a background check is there another name your data is associated with in the system. Example: recently married, divorced

Your answer

Co-Applicant Driver's License# and Issuing State

Your answer

Co-Applicant Birthdate

YYYY

Length of time at current residence *

Your answer

If less than a year at current residence, please list complete address, street, city, state and zip code of prior residence below:

Your answer

Telephone Number and Alternate Number to contact you directly. *

Your answer

Best times to contact you: *

Your answer

Adopter/Foster's Employer *

Your answer

Types of dogs you would be interested in fostering/adopting: *

Puppies (1 year and younger}

Adults (1 to 6 years)

Seniors (6years plus)

Special Needs: physical or behavioural needs

Hospice

Pregnant Mom (Mom and puppies after birth)

Where will the dog stay while you are not home on a daily basis? *

Your answer

On average, how many hours a day will the dog be alone? *

Your answer

Type of Dwelling. *

House

Apartment

Townhome/Condo

Do you own or rent your dwelling? *

Own property

Rent property

If renting, landlord's name and phone number:

Your answer

Do you have a fenced yard? *

Yes

If fenced, what type and height is your fence?

Your answer

If no fence, how do you intend to exercise the dog? Not having a fence will not automatically disqualify you from adopting, but may limit your options as to which dogs you qualify to adopt.

Your answer

Where do you intend the dog to stay when you are out of town, away from the home for an extended period of time? *

Your answer

Name of Adults (other then yourself) living in home who will be in contact with dog.

Your answer

Driver's license number and issuing state for adults (18+ years of age) living in the home other then Applicant and Co-Applicant

Your answer

List children under 18 years of age by name and age living in the home.

Your answer

Please list 4 references other than family and their PHONE numbers so we can contact them on your behalf: (Please let them know we will be calling) *

Your answer

Name of your veterinarian and telephone number: *

Your answer

List the animals under their care:

Your answer

Are all your current pets up to date with their core vaccinations? *

Yes

No ( We do not adopt dogs into homes where the current dogs are not kept up to date on core vaccination or use the titre test.

Not applicable

Are your current pets given heartworm preventative? *

Yes

Are your current pets given flea & tick preventative? *

Yes

Are all your current pets Spayed or Neutered? *

Yes

Not at this time ( We do NOT adopt dogs into homes where current dogs are NOT spayed/neutered, unless due to a medical condition)

Not applicable

If not up-to-date or altered due to medical issues, please explain why and the vet attending to the dog.

Your answer

If you use day care for your current/or past dog, please list the facility and phone number.

Your answer

In the past or currently, where did you attend training classes?

Your answer

Do you have any previous foster/adopter experience with a rescue?

Yes

Please list the organizations, contact name and telephone number?

Your answer

What type of role are you looking to provide? *

Fostering (The whole package, start to finish. I want to be their mentor and see them through to their forever home.)

Emergency Foster (If you have a dog in crisis, I can give them safe haven until placement is secured in a home.)

ISO Foster (I have no dogs and can proved a home for 18 days to ensure the dog is flu free)

Temporary foster for 2 to 3 weeks (I can take in a dog while other foster is on vacation or a dog is in limbo waiting to move into home)

Foster to adopt (I want to adopt the dog I will be fostering)

Pet Pal Foster (I can have a dog who is in boarding visit my home for the weekend to get a break and work on their in home skills)

Please let us know why you are interested in fostering/adopting; also list the dogs name you are interested in at this time. *

Your answer

Have you ever relinquished or rehomed a dog? If so, why and to whom. *

Your answer

Have you ever had to euthanize a dog for reasons other then quality of life prohibited by health issues? *

Your answer

Are you willing to allow for an adjustment period when the foster/adopted dog arrives? (Adjustment period estimated to be 3 to 6 weeks total, including a 2 to 3 week separation period to decompress. Some dogs adjust sooner than others, but we ask that the rules of engagement with dogs, people, ect., be followed regardless as recommended by our professional behaviorists and instructors) *

Your answer

Have you heard about the 2 Week Shutdown protocal in bringing a new dog into the home? *

Yes

Are you willing to attend training classes with the foster/adopted dog if rescue deems necessary for well being of the dog? (All dogs under the age of 1 are required to attend training with their new family as a prerequisite to adoption) *

Your answer

Are you familiar with Force Free and Postive Reinforcement Training? *

Yes, I have only used this method of training in the past and/or in the future.

No, but I am willing to learn and provide for the dog as the rescue deems necessary.

I am old school and don't subscribe to these new methods.

Have you ever Crate trained a dog? It's important that all dogs are crate trained should they have to spend time at a Veterinary or boarding facility. *

Yes

Have you ever house trained a dog? *

Yes

How much money do you expect to spend on your dog(s) this year on food, medical care & training?

Your answer

Do you or anyone in the home suffer from allergies that may require the dog being returned to rescue?

Your answer

Do you have plans to move out of state within the next year?

Your answer

Do you have a swimming pool, pond or body of water near your home?

Your answer

Have you, the applicants ever been charged with a felony? *

Yes, I am open to discussing. The conviction did not involve a violent crime.

Have you ever been charged with a violent crime?(Battery & Assault, Domestic Violence, Harassment) *

Yes, I am open to discussing in good faith that I will be an excellent dog guardian.

By signing below you are acknowledging your answers are truthful. You also acknowledge that K9 Enrichment Initiative, Inc. will be contacting your references and conducting a criminal background check. (Electronic signature accepted. You will be asked to initial this document should you be approved by a rescue) *

Your answer

A copy of your responses will be emailed to the address you provided.

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