Name:
Spouse's name:
Other adults in household:
Address:
City, State, Zip Code:
Home phone:
Work phone:
Cell phone:
Best time/number to call:	Best Number Home Work Cell
E-mail address:
Occupation:
Spouse’s occupation:
Please list ages and gender of children living in or regularly visit the home. If visiting please note how often.
Age:      Gender: ---------- Female Male      Live/Visit: ---------- Live In Visit      How often:
Age:      Gender: ---------- Female Male      Live/Visit: ---------- Live In Visit      How often:
Age:      Gender: ---------- Female Male      Live/Visit: ---------- Live In Visit      How often:
Age:      Gender: ---------- Female Male      Live/Visit: ---------- Live In Visit      How often:
Age:      Gender: ---------- Female Male      Live/Visit: ---------- Live In Visit      How often:
Age:      Gender: ---------- Female Male      Live/Visit: ---------- Live In Visit      How often:
Age:      Gender: ---------- Female Male      Live/Visit: ---------- Live In Visit      How often:
Age:      Gender: ---------- Female Male      Live/Visit: ---------- Live In Visit      How often:
Does anyone in your household have allergies to animals? Yes No
Do you own or rent your home?   Rent Own
If you rent, please provide us with your Landlord/leasing company manager's phone number:
List all names, types, ages, genders and indicate if spayed or neutered for all animals in household:
Name Type --- Feline Canine Other   Breed: Age: Gender: --- Female Male Spay/Neutered --- Yes No
Name Type --- Feline Canine Other   Breed: Age: Gender: --- Female Male Spay/Neutered --- Yes No
Name Type --- Feline Canine Other   Breed: Age: Gender: --- Female Male Spay/Neutered --- Yes No
Name Type --- Feline Canine Other   Breed: Age: Gender: --- Female Male Spay/Neutered --- Yes No
If there are no animals currently in the home than 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 our call to give permission for us to inquire about your past or current pet’s medical history.
Veterinarian:
Phone:
Address:
City, State, Zip:
How did you learn about HMDD? If from the Internet, which website?
Have you ever owned a Doberman before? Yes No
If yes, tell us a little about the one you had or have.
If not, why did you choose to foster this breed?
Do you have a fenced yard or area for the dog? Yes No
If yes, please list the type, height and square footage of fenced area for dog.
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?
Would you be willing to let a representative of the rescue program visit your home by appointment?   Yes No
Do you understand and accept the terms of the Fostering Agreement?  (view HTML version) 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.
Applicant Signature: Date:
After pressing "submit" you will be returned to the Fostering Procedures Page. Please allow 7-10 days for a representative to contact you to schedule a home visit. Please remember that our members are volunteers who work full-time jobs and commit to our program because of their love of the breed. Thank you!