Name (First & Last)     

Address:                     

City, Zip:                     

Home Phone:              

Cell Phone:                 

Email Address:           

Names and Ages of other persons living in your household:

Other Pets: (please specify species, gender, spayed/neutered, their attitude with other dogs)

Work Schedule: Select One Full Time Part Time Work at Home Dont Work

Prior dog experience: (Please explain)

Do you have a fenced yard? Select One Yes No

Do you own a crate? Select One Yes No

How do you plan to exercise your dog? (Please explain)

Will the dog live in the house? Select One Yes No

Why are you interested in fostering a homeless Labrador? (Please explain)

How much time and training are you willing to put into a Labrador? (Please explain)

What age, gender, etc. would you be willing to foster? (Please explain)

Please give three references, not family members, who would consider you to be a caring and considerate foster caregiver:

Reference 1: Name:   Address:

Phone:   Email:

Reference 2: Name:   Address:

Phone:   Email:

Reference3: Name:   Address:

Phone:   Email:

Please give the name, address, and phone number of your veterinarian that you use or are planning to use.

By completing and submitting this application, I understand, as a foster care-giver, that I will be responsible for my own liability and will not hold Miami Vally OKI Labrador and Referral responsible in any matter.