ESRA FOSTER HOME APPLICATION FORM

Your electronically submitted form will be used to expedite the approval process. Final approval will be pending a review by your region's application screening team and the receipt of a hard copy of your ORIGINAL SIGNED COPY of this form and the ESRA Code of Ethics.

SPECIAL NOTE: You need to complete this form on a device connected to a printer. Be sure to scroll to the very end of the form until you see “Click to Continue”. On the following page PRINT a hard copy to sign and send to ESRA as instructed, then before closing, click on the submit line to also send electronically.

Please use a desktop or laptop computer to fill out this form, as mobile devices (smartphones, tablets) are not always reliable for successful completion.

Very Important Hint: Use the "Tab" key or your mouse to move the cursor to the next field to fill out.
Hitting the "Enter" key will cause the form to be submitted immediately, even if it is not completely filled out.

 
Full name
Email address
Phone
Alt. Phone   This is:   work   cell   other
Street Address No P.O. boxes, please!
City State Zip Code

 

If approved, I will be fostering for ESRA as:
A foster home for any ESRA dog that will fit my dog-handling skills and home environment. (ESRA membership is required. Click here for membership application.)
A one-time foster home for a specific dog that needs extended time in foster care, usually for attention to medical needs or other type of evaluation. I hope to adopt this dog as my own when it is ready. (ESRA membership is welcome but not required.)
Special note: If your intent is to adopt, you should first complete the more detailed adoption application so that you are entered into our adoption system.

Do you own or rent your home?
Own Rent

Breeds with which you've had experience:

Describe what types of experience you've had with dogs and for how long:

Ever attended obedience classes? Describe:

Experience with other animals:

Dogs now in your household (breed, gender, age, altered?):

Other pets in household:

Children in household (name, gender, age):

Any medical or allergy conditions in family members:

How many and what gender dog(s) can you foster at one time?

Length of time you are willing to foster:

Fenced yard? (please describe):

Crate/s (type & size available):

Outdoor kennel or run (please describe):

Amount of time per day dog will be alone, and where:

Please list your vet and one other person knowledgeable about your care of dogs (trainer, groomer, breeder, etc.):
1. Vet's Name
Business Name
Email (if known)
Phone
Address
City    State
   
2. Reference Name
Relationship/Credentials
Email (if known)
Phone
Address
City    State
   

Your questions/comments:

 

 
 
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