Foster Application Form Name* Mr.Mrs.MissMs.Dr. Prefix First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Phone*Age*Under 1818-2122-2425-2930-3435-4445-5455-6465 or AboveFoster carer must be over 21.Your HouseholdDo you own or rent your current residence?* Own Rent Do you have the landlord's permission to have a dog? Yes No What type of residence do you live in?* Apartment Unit Townhouse House Acreage FencesHow high are your boundary fences?* Under 4ft 4ft 5ft 6ft+ No Fencing What are your boundary fences made of ?* Timber Colorbond Wire Mesh Brick Photos of Back fence: Drop files here or Select files Max. file size: 16 MB. Photos of Right Side fence: Drop files here or Select files Max. file size: 16 MB. Photos of Left Side fence: Drop files here or Select files Max. file size: 16 MB. Photos of any Gates: Drop files here or Select files Max. file size: 16 MB. Any other photos showing fencing: Drop files here or Select files Max. file size: 16 MB. Family InformationHow many children currently live or regularly visit your household ?*012345678910+What are their ages and exposure level to dogs ?Do you or anyone in your household have any allergies or medical conditions that we need to be aware of ?*What is your primary reason you want to foster a dog ?*Who will be responsible for the care of the dog ?*I agree to properly supervise my children when they are around the dog.* Yes No I agree not to allow my children to tease, torment, grab, pull on or hit the dog.* Yes No I agree to teach my children to never disturb the dog when it is eating or sleeping.* Yes No Other PetsAre there other pets in the home ?* Yes No Please list: Type, Breed, Age, Sex, Dog Friendly?Eg: Dog, Siberian Husky, 5 years, Male, Dog Friendly Eg: Cat, Burmese, 2 years, Female, Not Dog FriendlyAre your pets desexed? If not, why ?Are these pets up to date on vaccines ?* Yes No If you have a regular vet please provide details:Eg: Johnston St Vet Clinic, Dr Will Ryan, Ph: 9416 3788Have you ever surrendered a pet ? If so, why ?Have you had a pet euthanised ? If so, why ?Commitment and ResponsibilityDo you have time to provide adequate love and attention to your foster dog ?* Yes No When the dog goes out, how do you plan to supervise it ?*Where will the dog stay during the day ?*Please describe where the dog will sleep at night:*Where will the dog stay when you are not home ?Hours per day will the pet be alone:* How much time are you prepared to allow for your new pet to adjust to your home ?*Can you walk your dog at least once a day ?* Yes No Have you ever housebroken a dog ?* Yes No What do you feel is the best way to discipline a dog ?*What would you do if your foster dog develops a problem with any of the following. If this were to happen could you keep this pet and continue to work with any of these issues: Housebreaking: Digging: Barking: Chewing: Separation Anxiety: Escaping/Running Away: Aggression:*Under what circumstances would you not be able to keep your foster dog ?*I will never allow any physical, mental, or emotional abuse of the dog* Yes No Do you have any experience training and working with dogs with behavioural issues? Please give details.Have you ever owned a Siberian Husky or any Arctic Breeds?* Siberian Husky Other Arctic Breed No From what date are you available to start fostering ?* DD slash MM slash YYYY Will your foster dog be allowed off lead in unenclosed areas ? Yes No Other InformationDo you foster for another organisation ?* Yes No Do you agree to let a representative of Homes For Huskies Rescue Inc. visit your home by appointment ?* Yes No Is there any other information you wish to add or any other questions you have at this time? (this is your chance to personalize your application).By pressing the Submit button, you attest that all of the information you have provided in this application is true and correct. Thank you for taking the first steps in giving a Siberian Husky a new beginning.