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Last Name
Address
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Zip Code
Age
Home Phone #
Occupation
Work Phone #
Cell Phone #
Your Email Address
Which of the following best describes your current residence?
Single Family Home
Duplex
Town House
Apartment
Condo
Mobile Home
Rent
Own
If you rent, do you have your landlord's permission to keep a dog?
Do you have a fenced yard on your property?
No
Yes
If Yes, what type of fence?
Wood
Chain Link
Block
Other
If other, please describe
How high is the fence?
Is someone home during the day? Please explain.
What provisions will be made for your foster Brussels Griffon if no one is home during the day?
Loose inside
In Crate
In fenced yard
Where will the foster Brussels Grifffon sleep? Please explain.
Do you have children living with you?
Yes
No
If yes, what are their names and ages?
How many adults reside in your home?
What are their names, ages, and relationships to you?
Please list all the pets that have lived in your house in the last two years and if they are not with you now where are they?
Number of pets currently in your home?
Please list the name, kind, age, and sex of your current pets.
Are the pets spayed/neutered?
If resident pets are not spayed/neutered, please explain.
If you have dogs/cats, are they vaccinated and on heartworm preventative?
Personal References:
Name of First Reference (other than relative)
Phone (example: 555-123-1234)
Relationship to you
Name of Second Reference (other than relative):
Phone (example: 555-123-1234)
Relationship to you
Vet's Name
Vet's Phone Number
What name are medical records listed under at your vet's office?
Do your pets get along with other animals?
No
Yes
ABGRA will provide for all medical care, heartworm and parasite preventative. Are you prepared to assume the responsibilities of feeding, bathing, grooming and caring for your foster Griffon, including emotional rehabilitation for a traumatized dog and crating for a dog going thru heartworm treatment?
No
Yes
Will you follow all Veterinarian instructions provided and administer all prescription medications and Heartworm Preventative to your Foster Griffon?
No
Yes
Will you stay in close contact with your ABGRA contact person and keep him/her appraised of progress, problems, medical issues, and updates on you foster dog?
No
Yes
Are you ready to recognize that while your input is valued, responsibility for final decisions about the future of all of our Rescues lies with ABGRA?
No
Yes
Will you let ABGRA know if you are planning to take your foster Griffon out of town or state for family visits or recreation?
No
Yes
Although ABGRA does not accept vicious dogs into our program, we do not know the histories of many of our rescues. Are you prepared to contact ABGRA immediately if your Foster Griffon bites anyone or seriously injures another pet?
No
Yes
Will you keep the dog confined in a fenced yard when let outdoors, walk/exercise the Foster Griffon on lead regularly and allow the dog to live indoors?
No
Yes
Do you understand that Griffons are known for being "barkers" and that your foster Griffon may not be housetrained?
No
Yes
Do you understand that Griffons can be shy and aloof with new people?
No
Yes
Foster parents are encouraged to maintain an "Aunt" or "Uncle" relationship with the Griffon in their care. However, occasionally the foster parent and the Griffon will bond so completely that adoption into this home is best for the Griffon and family. Do you understand that if you wish to adopt your Foster Griffon you must complete the Adoption Application & Adoption Agreement and make a donation, as would any other adopter?
No
Yes
Are you willing to allow a ABGRA representative to visit your home by appointment?
No
Yes
How did you hear about The American Brussels Griffon Rescue Alliance?
Internet
Vet, Clinic or Shelter Referral
Breeder
Dog/Obedience Club
Other Rescue Group
Friend/Neighbor
Other
I am in full agreement with The American Brussels Griffon Rescue Alliance Foster Care Responsibilities. By signing below I am attesting to the truthfulness of my answers.
I hereby forever release, discharge, and agree to hold harmless and indemnify American Brussels Griffon Rescue Alliance; its board of directors; and its members, Officers, and agents from all claims, demands, actions, causes of action, or liability of any kind whatsoever arising as a result of or in connection with the fostering or adoption of a dog sponsored by this organization.