This form was created in order to help us find foster homes in New Jersey and surrounding areas. Please fill in all information. Thank you for your time and willingness to help.

I am willing to foster a: (check all that apply)



pit bull

adult dog > 40 lbs


pregnant/whelped with puppies

Applicant Information

Name (first) (last)
Co-Applicant Name (first) Co-Applicant Name (last)
Street Address
Home Phone (with area code) - -
Email Address @
Business Phone (with area code) - -
Cell Phone (with area code) - -

Household Information

Number of Children: Their ages
What breed(s) of dogs have your children lived with? 
How long have you lived at this address? 
Which best describes your current home? 
Do you currently:
Please provide the name and phone number for your landlord (renters) or land owner (mobile home)
Name Phone Number
Besides your immediate family, who else lives in your home (name, age, relationship)?

Does your home have a yard? Yes No
Is it completely fenced?  Is gate padlocked? Is fence secure underground? (please provide

Foster Information

What provisions will be made for your pet when no one is home?

Do you prefer to foster a male or female dog? Male Female Either

Current Pet Information

Do you currently have any pets? (List type, breed, age, and gender)

Tell us about the pets you have owned over the past 10 years, i.e. type of pet(s), how many years you owned them, reason for no longer owning them.

Veterinarian's Name & Phone Number. Please also tell us what name the pet is listed under at the vet's office.

Are your pets current on vaccinations? (list each pet separately)

Are your pets spayed/neutered? (list each pet separately)

Are your pets on heartworm preventative? What brand?
When did you visit your veterinarian last?

All of the dogs placed have undergone thorough temperament evaluations and live with foster families prior to their adoption. While in foster care, we begin training and work to resolve any behavioral obstacles before adoption. Generally we are only able to give you the dog's history from the time it enters our program. Are you able and willing to continue working on these challenges with us to ensure that your adopted dog is a respectable canine companion and family member? Your comments are encouraged.

Do you have a crate available for your foster dog? Yes No
Do you have time to continue this dog's training while in your care? Yes No

Please provide the name and contact information of two persons who have been to your home and interacted with you and your pets.

Reference #1 Name:
Reference #1 Relationship:
Reference #1 Evening Phone#: - -
Reference #1 Email Address:

Reference #2 Name:
Reference #2 Relationship:
Reference #2 Evening Phone#: - -
Reference #2 Email Address:

Additional Comments:

I certify that the information I have provided on this form is true, correct, and accurate. I understand and agree that falsification of any of the above information is grounds to disqualify my adoption application and nullify all adoption(s) and/or adoption agreement. I understand that there is no obligation to place an animal with me now or in the future. I understand that my electronically-generated signature [below] is valid as a means of legal signature for the purpose of this adoption application.
(Please respond with Yes or No)

Signature: Date: