Foster Application
Please email the Webmaster concerning problems with this form.

 
 



 




 
First Name
Last Name
Address
City
State
ZIP Code
Email
Confirm Email

Please list all members in your household other than yourself and ages:

Name

Relation
Age

Please list all pets owned in the last 5 years

Name
Breed
Years Together
Age
Home Now?
Altered?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No

If you have owned more than 3 pets or need more space for your pet history,
please use the text box below to complete the requested information.

Veterinarian Information

Veterinarian Name
Street Address
Town or City

 Zip Code
Vets Phone
Veterinarian Name
Street Address
Town or City

 Zip Code
Vets Phone

IMPORTANT! Some vets require you to provide verbal permission before records are released to us. PLEASE CONTACT YOUR VET & ADVISE THAT ELEVENTH HOUR RESCUE WILL BE CALLING FOR A VET CHECK AND PROVIDE PERMISSION to release your record's.

If you have taken your animals to more than one vet, then we need to have the name, phone number and address of all the other vets your animal has received treatment with:
If you have never owned a pet or if your last pet has been deceased longer than 5 years, please provide two references: One reference can be a family member. The second reference must be a non-family relation, such as a coworker or boss.

Name
Phone Number
Relationship to You

Do you own your home? Yes No
If renting, please list your Landlord's Name
Landlord's Phone Number

Do you have a Fenced Yard? Yes No
How do you plan on letting the dog outside?

Will you crate train the dog? Yes No
If no, where will the dog be kept when you are not home?

If you want to foster care for puppies, please note your experience:
Please note that only FULLY completed applications will be considered. Once the application has been reviewed and approved or denied, you will be contacted via email or phone. Please check your email for the notification. You will be notified of the approval within 7-10 days providing that your application was complete in the information required.

By clicking on the submit button below, I hereby give permission to the Eleventh Hour Animal Rescue to contact my veterinarian to obtain information about past and present pets. I also confirm I am 18 years of age or older and authorize the rescue to verify the above information.

The Eleventh Hour Rescue shall not be held responsible for any damages, costs, or expense resulting from this placement; including, but not limited to, damage or injury to persons property. In this connection, Eleventh Hour Rescue is harmless from any and all liability of any and every nature and cause, directly and indirectly relating to the fostering of any dog.

One or more home visits may be made with or without prior notice, and I hereby agree to this. The Eleventh Hour Rescue may examine and/or make inquires about the dog at any time. If Eleventh Hour Rescue is not satisfied with the manner in which the dog is being kept the dog may be immediately reclaimed . Reclaiming of the dog shall not be considered a trespass or theft.

The dog must be made available to adopters and Eleventh Hour Rescue as necessary. By summiting this form, you agree to all of the above terms.