The Shih Tzu Rescue Application. Thank you for your interest in helping us with rescue.  This is the foster application we would like you to fill out.  Please answer all questions. How would you like to help us in our rescue efforts?  Please select all boxes appropriate. Fostering Making Follow up calls after adoptions. Doing Home Visits. Helping with Fund Raising. Doing Reference Checks. Transporting From Shelters. Me and My Family. First Name Last Name Street City State   Zip       Home Phone Work Phone Cell Phone Best time to call E-Mail address How many people live in your residence Name and Ages Your Home. Which of the following best describes your current residence. Select residence Own single family home Rent/lease single family home Own a townhouse, or condominium Rent/lease an Apt., T House, or Condo Other (Please explain) (Other) If you lease or rent please provide your property manager's name and phone number. Name Phone Does your lease or home owners association have any covenants or restrictions on pet ownership?  If yes, please explain. Yes  No   (Restrictions) Does your town or city have any restrictions on the number of dogs you can have?  If yes, please indicate. Yes  No   Maximum number of dogs. Yes  No Is your yard, or a portion of your yard securely fenced? Yes  No If you have a pool, is it fenced? Yes  No If you have a dog run, is it secure? Preferences (For Fostering Only) Yes  No Are you willing to foster dogs with special needs? Yes  No Are you willing to foster dogs with a history of neglect/abuse who need extra love and attention? Yes  No Are you willing to foster dogs with behavior problems who require special training? Yes  No Are you willing to foster "Puppy Mill" dogs and socialize them? Yes  No Would you consider fostering a Shih Tzu mix? What restrictions would you have about fostering a dog? How long are you willing to foster a dog? Select Time 1 Day 2 Days 3 Days 4 - 7 Days 1 Week 2 Weeks 3 Weeks 4 Weeks 1 Month 2 - 6 Months 1 Year Or Longer   Selection in days, weeks, months How many dogs will you foster at one time? Select Dogs 1 Dog 2 Dogs 3 Dogs 4 Dogs 5 Dogs 6 Dogs 7 Dogs 8 Dogs 9 Dogs 10 Dogs   Select the number of dogs. Care and Responsibilities (For Fostering Only) Yes  No Are you willing to take dogs to a veterinarian as soon as you get them for medical assessment? Yes  No Will your veterinarian offer you a discount? Yes  No Will you be able to take foster dogs to a groomer? Yes  No Will your groomer offer you a discount? Yes  No Can you spend approximately15 minutes a day brushing and combing out your foster dogs? Yes  No Are you prepared to do all the routine care of the foster dogs; like cleaning the eyes, ears, etc. Yes  No Are all members of the family willing to help you foster dogs? Yes  No Will you allow the fosters to mingle and socialize with family and pets after the quarantine period? Yes  No Do you have a separate quarantine area? If not, how do you plan to keep the dogs separate? Approximately how many hours will the foster dogs be left alone? How Many Hours Alone 1 Hour 2 Hours 3 Hours 4 Hours 4 - 8 Hours 8 - 12 Hours 12 - 16 Hours 16 - 24 Hours More Than 12 Hours   Select the hours alone. Where will the foster dogs stay while you are away? Where will the foster dogs sleep at night? Knowledge about Shih Tzus Yes  No Do you personally own a Shih Tzu? If not, how much knowledge do you have about the breed.  (Please explain) History of Pet Ownership What dogs currently live with you? Dog's Name Breed Sex Spay/Neuter Age (M/Y) How Long Where Kept 1 M F S N 2 M F S N 3 M F S N Please List any additional dogs Yes No Do you have any other animals? Name Breed Sex Spay/Neuter Age (M/Y) How Long Where Kept 1 M F S N 2 M F S N Please list dogs you have owned in the past and explain what happened to the dog. Name Breed Sex Age(M/Y) How Long What Happened to the dog 1 M F 2 M F 3 M F Please list any additional dogs References  References Name Phone Number Veterinarian Groomer Relative Include State or Country Friend Include State or Country Neighbor Include State or Country Any additional information you would like to add to help us to better help you become a Rescue Volunteer. All of the information I have provided is true and complete to the best of my knowledge. Applicant Name Date The information on this form is for the evaluation and use of Shih Tzu Rescue and will not be shared with any third party.