Foster Care Application Form Foster Carer Applicaiton Step 1 of 2 50% Personal DetailsDate* First Name*Last Name*Address* Unit and or Street Number Street Name Suburb State Post Code Phone*Work or other Phone NumberEmail* Emergency Contact Name*Emergency Contact Phone Number*Occupation*Full timePart timeStay at home MumCarerRetiredNot employedDriver Licence No. or ID Card No.*Municipality/Council*Foster Pet Details and InformationHave you fostered a dog before?YesNoPlease give details*Size, age, breed etc,.How long are you able to commit to fostering a dog?0-6 months1 YearLong termDo you have prior experience that would be helpful with Fostering a Dog?*YesNoPlease give details*Do you have any experience training or working with behavioural issue dogs?*YesNoPlease give details*What type of dog are you interested in fostering?*ToySmallMediumLargeI would consider fostering two Dogs*YesNoPossiblyWould you consider fostering a Dog with Special Needs*YesNoMaybeWhat type of special needs dog would you consider?*Three Legged dogDeaf/blindEx Puppy Farm dogHave you owned special needs dogs before?*YesNoPlease give details*Do you have any Dogs currently?*YesNoPlease give details of Pet type, age, sex, temperament, activity levelDoes your current dog have any behavioural or socialisaton problems?*YesNoPlease give detailsIs pet desexed?YesNoPlease give details*Is pet Vaccinated?*YesNoHave you owned Pets before?*YesNoPlease give details i.e. type, breed, how long you owned your pet, any other relevant information.Do you currently have any other pets?*YesNoi.e. Cat, Rabbit, Guinea PigsPlease give detailsWhere do your existing Pets sleep?Please be specific i.e. In laundry with access to outsideWhere will your Foster Dog sleep?Please be specific i.e. In laundry with access to outsidePlease give details i.e. type, breed, age and any other relevant information.How confident are you in caring for Dogs?Very ConfidentConfidentNot confident and would appreciate help to begin withAvailable time you have to exercise your foster Dog?5-7 days per week3-5 days per week1-2 days per weekNot at allIf going on holidays what plans to you have for your Foster Dog?Boarding KennelPet SitterStay with friendsOtherPlease give detailsWould you be prepared to housetrain your Foster Dog if required?YesNoWould you be prepared to access training for your Foster Dog if required?YesNoPlease give details*Dwelling detailsResidential details*HouseTownhouseUnitVillaOtherResidental Details - OtherDo you*OwnRentShareBoardIf Renting, please upload written Body Corporate, Strata or Landlord approval hereTime living at current premisesLess than a month1-6 months1-3 yearsOver 3 yearsIs your yard fully fenced with lockable gates?*YesNoOtherArrangements/Shelter available*IndoorOutdoorIndoor/OutdoorKennelCarportGarageLaundryFree access to all areaPlease give details?*This includes verandahs and balconiesAre there pools, spas, ponds, waterways or dams?YesNoPlease give details belowPlease include description of fencing already in place, is it Dog proof etc,.Is local traffic*QuietHeavyBusyOtherPlease give detailsCurrent Resident DetailsNumber of Adults living in the home?*Do you have children living at home?YesNoList ages of all children living at homeAre there known fur or dander allergies amongst residents?YesNoPlease give details*Is everyone in the home supportive of Fostering a dog?*YesNoUnsureDo your neighbours have dog(s)*YesNoUnsureAre neighbouring dogs securely confined?*YesNoUnsure Have you or anyone in your household been convicted of Animal cruelty, neglect or had an animal removed from your care?*YesNoPlease provide details*Is there anything else you would like us to know?Please tell us more about your you, your family or your interest in Adopting a dog.Please provide the name and contact details of at least 2 referee's whom you have known for 2 years or more* By checking this box you agree to allow us to contact your referee's Referee No. 1 First Name Last Name Phone*Email Relationship to you i.e vet, employer, friendReferee No. 2 First Name Last Name Phone*Email Relationship to you i.e vet, employer, friendAs a foster carer you will be required to stay in regular contact with GOAR and at least one of their representatives (in most cases Gina) You will need to provide regular updates on your your foster dog and send clear photo's of your foster dog that can be used to advertise your foster pet for adoption once they have had their vet work completed and recovered. Are you willing to do this?*YesNoYou must use the vet clinic Gina Fallon has approved in your locality.Once being approved as a foster carer you will be given a list of contacts to call before taking the dog to the vets.If you this hasn't occurred, please contact Gina to arrange an approved vet clinic prior to seeking non emergency vet treatment*YesNoIf you decide you cannot part with your foster dog and want to adopt you need to go through the normal adoption procedure and the final decision is made by Gina, a prescribed adoption fee will be required. Understanding that GOAR has incurred vet bills that far surpass the adoption fee.*YesNoIf you become uncontactable via phone or email the following will occur 1) the animal will be marked missing/stolen on the companion animal register 2) the vet clinic where the dog is normally taken will be contacted and advised GOAR will not be accepting any vet bills incurred by you from said date.and advised if the animal is brought into the clinic the police are to be contacted immediately as the dog is considered to be stolen. Do you understand this?*YesNoFor the first week a foster dog may be unsettled and scared. The dog may be very confused about their new situation and take some time to adjust. Are you willing to give your foster dog time to settle into your home? Marking of furniture is commonly seen in foster dogs especially when in a new environment. Is this some thing you are willing to work on with your foster dog?*YesNoI am over the age of 18 years*Legally you must over the age of 18 to adopt an animalYesNoI have not provided false information. All information supplied is true and correct and in no way misleading.* Agree Disagree Date* Name* First Last You may be asked to sign this form at a later date in the process. We will be in touch very soon!PhoneThis field is for validation purposes and should be left unchanged.