Name: Spouse's Name: Other Adults in Home:

Address: City: State: Zip Code:

Email:

Home Phone: Cell Phone: Work Phone: Best Number to Call Home Cell Work Best Time to Call Morning Day Evening Anytime

Your Occupation Your Spouse's Occupation:

Please list ages and gender of children living in or regularly visiting the home. If visiting please note how often.

Child 1- Age: Gender: N/A Male Female    Live or Visit: N/A Live Visit If visit, how often?:

Child 2- Age: Gender: N/A Male Female Live or Visit: N/A Live Visit If visit, how often?:

Child 3- Age: Gender: N/A Male Female Live or Visit: N/A Live Visit If visit, how often?:

Child 4- Age: Gender: N/A Male Female Live or Visit: N/A Live Visit If visit, how often?:

Is anyone in your home allergic to animals? Yes No

Do you own or rent your home? Own Rent Type of home Single Family Apartment Condo Mobile Home If you rent, please provide landlord/leasing company name & phone number:

For all other animals in the home, please list name, type, gender, and indicate if spay or neutered:

If there is no dog currently in the home, then please describe your last dog and what happened to it.

A representative from the rescue program will be contacting your veterinarian for a reference. Please call your veterinarian prior to give permission for us to inquire about your past or current pet’s medical history.

Veterinarian Name: Veterinarian Phone: Veterinarian Address: City: State: Zip Code:

How did you learn about Hand Me Down Dobes?

Have you ever owned a Doberman before? Yes No If yes, tell us about the one you had.
If no, why did you choose to foster this breed now?

How many hours in a typical day will the dog be left alone? Where will the dog stay when you are not home?

Do you have a fenced yard or area for this dog? Yes No If yes, tell us about the type, height, and square footage of the fenced area.
If no, what arrangements will you have for the dog’s exercise and elimination requirements?

Where will the dog spend the day? Where will the dog spend the night?

Are you willing to let a representative of the rescue program visit your home by appointment? Yes No

Hand Me Down Dobes, Inc., reserves the right to follow up on the fosterer in order to protect the welfare of the placed dog. If the terms and conditions of this agreement are not upheld by the fosterer or if any misrepresentations have been made, Hand Me Down Dobes, Inc. reserves the right to terminate this agreement and the fosterer must return the dog to the rescue program.

RELEASE OF LIABILITY

I understand that neither Hand Me Down Dobes, Inc., nor any of its representatives, is responsible for the accuracy of the information received about the temperament, habits, or physical condition of the dog available for fostering. I am in full agreement with the terms of Fostering Agreement. In redeeming a dog from the program, I accept full and complete responsibility for that actions of the dog in the event of an injury or death to myself or others and to indemnify and hold harmless Hand Me Down Dobes, Inc., including its representatives, agents, and board members for any such personal injury, death, or damage caused by such dog now or in the future.

Signature (Please type your name and today's date)