Biscuit Foundation. The. Personal Information. Date: / / Case Number The Biscuit Foundation P.O. Box 2281 Burlington, NC Phone:

Similar documents
American Bullmastiff Association Inc. Rescue Service - Florida Division

APPLICATION FOR PLACEMENT OF SPECIAL EMANUEL HOMESTEAD GOLDEN PUPPY CLIENT INFORMATION SHEET 2015

Bird s Name Species. Owner s Name. Address. City State Zip Code. Home Phone Work Phone. Fax

SECURE TRANSPORTATION SERVICES

CARE PLAN REVIEW FORM

5 THINGS HOME SELLERS DO THAT HOME BUYERS HATE

Lodger Information Pack

Interviewing and Selecting Your PA

Enlightened Psychotherapy

Cards are divided into 6 categories: My Self My Feelings My Body My Family My Friends My World

Created and Distributed as a Courtesy of SWD Homes, Inc Buford Hwy., PMB #C184 Buford, GA

Evictions and Lockouts

SCENARIO CARDS (ANGER) SCENARIO CARDS (ANGER) SCENARIO CARDS (ANGER) SCENARIO CARDS (ANGER)

The Layoff Checklist

Non-Police Personnel Vetting - (NPPV) Basic

Town of Siler City - Unified Development Ordinance - Table of Permissible Uses

Enlightened Psychotherapy

A Step-by-Step Guide to Support Planning

Here s how to complete a Health Care Proxy:

Getting Started In Social Media For Animal Shelters and Rescue Groups. Christie Keith

11-13 Year Well Child Exam Form - FEMALE

Before you start planning your career goals for 2018, here are a few suggestions:

Where Does My Job End and My Purpose of session: To start you on a journey to help you take better care of your life and to find a balance between you

Family Autobiographical Information Child Foster Care

< The Family Demographics table contains the family demographic data, including home address and phone number

WELCOME PACKET WHY WALK? TOOLS WHAT SHOULD YOU DO NEXT? Dear Participant,

isns Health Care Treatment and Consent

QUESTIONS. before marriage T O A S K F R O M T H E D A T I N G D I V A S

HEALTHSPRINGS 360 REVIEW OF SYSTEMS CIRCLE IF THE ANSWER IS YES

A PRACTICAL GUIDE FOR ADVANCE CARE PLANNING

Share wave 5: 50+ in Europe - Coverscreenwizard version 5.4.2

Premarital Counseling Questionnaire

Applications form: Standard / Enhanced Disclosure

Proceedings of the 36th World Small Animal Veterinary Congress WSAVA

CLIENT QUESTIONNAIRE PLEASE FULLY COMPLETE THIS FORM, PRINT CLEARLY. DO NOT LEAVE ANYTHING BLANK. PUT N/A IF THE QUESTION DOES NOT APPLY TO YOU.

NANNIES ON CALL NANNY APPLICATION

PICKENS COUNTY RECREATION DEPARTMENT

Track Laying Skills By Rosemary Janoch

Young at Heart Annual Holiday Craft Fair Vendors Needed!

Getting Started Tool Kit

Decluttering The Kids Rooms

Employment Application

Part One of Five. What happens every 49.5 seconds? D A B D A: Limitations of DABDA. Support staff notes. Importance of The Story

2. Please use maiden names where applicable, and all given names of ancestors.

CHOOSE YOUR OWN ADVENTURE

PERFECT NEST PROGRAM NEEDS ANALYSIS

Preferences for Everyday Living Inventory- Nursing Home Version (PELI-NH-Mid)

1) Name: 2) Address: City State Zip Code. How did you hear about us?: Primary contact Phone # ( 2 nd contact Phone # ( ) -

Employment Application

Choose Your Studio Type

SUCH A CONVICTION WILL NOT NECESSARILY DISQUALIFY YOU FOR THE POSITION YOU ARE APPLYING FOR

A GUIDE FOR TEAM FUNDRAISING

Structured Trauma-Related Experiences and Symptoms Screener (STRESS)

PREPARE. A guide to help people and their loved ones prepare for medical decision making. Name:

LIST BUILDER TOOL KIT

FUNdraising Ideas. MSillinois.org

Youth Build Evansville

CHILDREN S GUIDE 5-12YRS

MINISTERIAL DIRECTIVE TO SERVICE MANAGERS UNDER S OF THE HOUSING SERVICES ACT, 2011

How to complete the Tier 4 (General) Student visa application online

move in guide

B. 1. Tuesday 2. schedule 3. classes 4. ends 5. library 6. finished 7. language 8. lesson 9. learning 10. tired. Unit 1 My Busy Schedule

CIVILIAN PERSONAL HISTORY FORM

How to Combine Records in (New) FamilySearch

What s Going On? A Coloring Booklet for Children in Foster Care

Mike Ferry North America s Leading Real Estate Coaching and Training Company TRIGGER CARDS

Set a goal for how many people you want to recruit to your team (6-10 is a good amount).

IELTS Speaking Questions & Topics for Part One. I d just like to ask you some questions about your hometown. IELTS buddy

What is it and how to do it

I will know that I am "out of the crisis" and ready to use this post crisis plan when I:

Toolkit Recruiting a personal assistant

JANUARY Catawba Valley Gem & Mineral Club, Inc.

Healthy Pets Healthy Families Calendar

The World of Work. This is an survey, NOT a test. Place a check mark in the column that indicates your honest response for each of the items.

Southern Nature Art Exhibition

The Listings Handbook

Collection of. Discovery Questions

The Institute for Population and Social Research, Mahidol University and Carolina Population Center, University of North Carolina at Chapel Hill

Resident Application

Welcome to PEP. Disclaimer 4/3/2017. SALES ASSOCIATE SESSION 2: Prospecting Your Sphere of Influence Social Media

Get Well Soon Helping you make a speedy recovery after your Laparoscopic Nephrectomy

The Coffee Shop Interview. Transform your relationships and your business through great conversation

This is the official questionnaire for this address. It is quick and easy to respond, and your answers are protected by law. DRAFT

The Quilt Pattern Magazine Pattern Submission Expiry date for this form is

Scripts to Overcome the Toughest Buyer Objections and Close More Sales

Raleigh-Durham Caged Bird Society PO Box Raleigh, NC October 2014 VENDORS, ADVERTISERS, & RAFFLE DONORS

CHAPTER 1. Reflections on Your Present

CHRIST THE KING CATHOLIC CHURCH 7680 Gulf Highway Lake Charles, LA (337)

Advice on How to Manage Your Relationships

Your Memory Book and Memory Box

love in the name of blog: askmonicaberg.com

Self-Marginalization. How I Retrieve Myself and the Meaning of It. By Hiroko Sano

Young at Heart Senior Citizen Club, Inc Holiday Craft Fair Vendor Application Friday November 2 nd 4pm-8pm & Saturday November 3 rd 9am-4pm

Aaminah Shakur LETTER 3: IT WASN T YOUR FAULT

MASTERING PROSPECTING SCRIPTS

Somerville College, Oxford. Admissions interview information (for applicants to standard courses)

REFERRAL PLAYBOOK STEPS FOR MORE REFERRALS

The Senior Portrait Telechart

What is the NCAA Eligibility Center?

1. Consider each characteristic listed in the first column and think about the degree to which you possess this quality.

Transcription:

The Biscuit Foundation Helping people and their pets... one paw at a time The Biscuit Foundation P.O. Box 2281 Burlington, NC 27216 Phone: 336-266-6000 Foster Home Application We would love to have you join our network of foster families. Our goal is to be able to help people and their pets and in order to do that we need your help! We will cover all veterinary expenses with our veterinarian. We ask that you furnish the food, pet dishes, a bed, toys and lots of love. Please answer all of the following questions as completely and honestly as possible - the more details that you can give us, the easier it will be to match you up with the best foster pet for your situation. After we receive your form we will contact you to discuss your application. Your veterinarian will be contacted to verify your pet s information. At that time a Biscuit Foundation member will arrange for an in-home visit. Thank you for volunteering to save the life of a wonderful pet. Personal Information Name: Spouse: Address: City: State: Zip: E-mail: Home Phone: Cell Phone: Your Employer: Work Phone: Spouse s Employer: Spouse s Work Phone: Your Age: Spouse s Age: Are you expecting a child or planning a family? o Yes o No Does your or your spouse s job require frequent out of town travel? o Yes o No Are you or your spouse subject to relocation? o Yes o No Are you a student? o Yes o No Are you in the military? o Yes o No Note: all foster pets will be current on vaccinations and free of internal and external parasites. Foster Home Application Page 1

Family Information How many family members live in your home including yourself? List the ages of the family members living in your home: Besides your immediate family, are there others residing in your home? o Yes o No List the ages of the others living in your home: Home Information Do you own or rent? o Own o Rent If you rent, please provide name and phone number of your landlord. How long have you lived at your current address? Please describe your neighborhood: Does your home have a yard? o Yes o No Does fencing completely enclose the yard? o Yes o No Foster Home Application Page 2

Home Information cont d If not, explain how and where you will allow a dog to exercise and relieve itself? If your yard is fenced, please describe what kind: How tall is your fence? Is the gate currently locked with a padlock? o Yes o No Can strangers gain access to your yard from the street? o Yes o No Some insurance companies may cancel your homeowner s insurance if there is a pet on the premises. It is your responsibility to check with your agent to ensure that fostering a pet will not adversely affect your policy. Other Pet Information Do you have others pets at this time? o Yes o No If yes, are they spayed or neutered? o Yes o No If yes, are they currently on heart worm preventative? o Yes o No o N/A If yes, are they indoors or outdoors? o Indoors o Outdoors Please describe in detail the perfect pet for you, including age, sex and temperament: Foster Home Application Page 3

Other Pet Information cont d Do your pets get along with (tolerate) other animals? o Yes o No If no, please explain: Have you ever fostered a pet before? o Yes o No Do you prefer a pet that will be primarily fostered indoors or be primarily fostered outdoors? o Indoors o Outdoors Please describe where the pet will stay when you are at home: Please describe where the pet will stay when you are away: Please describe where the pet will sleep at night: How many hours per day will the pet be alone? Do you have a crate? o Yes o No Do you plan to use a crate? Why or why not? If yes, how many hours per day will the pet be crated? What kinds of solutions would you be willing to try if housebreaking accidents occurred? o Crate o Leave outside o None, I would need to return the pet o Other (specify) Foster Home Application Page 4

References Many veterinarians will not release information to us without your permission. Please let your vet know that someone from The Biscuit Foundation will be calling them and that it is OK to release information to us. I called my veterinarian(s) on this date: and I spoke with: to let them know that someone from The Biscuit Foundation will be calling and I have given my permission for them to release information to you. Please provide us with your current veterinarian information (required): Address: City: State: Zip: Phone: Please provide three references not related to you: Reference # 1: Reference # 2: Reference # 3: And Finally... Do you mind if families interested in adopting a pet come to your home to visit it? o Yes o No Do you have a pet gender preference? o Yes o No Do you have a pet age preference? o Yes o No Do you have a time frame regarding how long you will be able to keep the pet or pets? o Yes o No Please explain: If you were referred to us by anyone, please tell us so we can thank them. Foster Home Application Page 5