Foster/Adoption Form ADOPTION/FOSTER APPLICATION Adopter Name(s) (required) Address City State Zip Phones (home) Cell Work How long at this address? OwnRent If renting or townhome association, name and phone of landlord/association. Please note that a home visit/tour is part of the approval process. If you live outside the Twin Cities metro area, it may take us longer to arrange for your home visit. If approved, you may be asked to drive to the Twin Cities to meet the dog. Email Address Do you check your email every day? YesNo How did you hear of Top Dog Foundation? (Referral, veterinarian, Internet, advertising, etc.) List name, breed, and age of all current pets in your household and indicate if they are spayed/neutered: Name Breed Age Spayed/Neutered? What former pets (name, breed, age) have you owned in the last 10 years and what happened to each of them? (If deceased, please explain circumstances): Name Breed Age Disposition Emergency Contact if you are unable to care for the dog Name Address Phone Please contact your veterinary clinic to authorize the release of information to Top Dog Foundation Veterinarian name Phone Number Providing this information authorizes TDF to discuss information about your current and past pets with your veterinarian. Are/were your pets current on vaccinations? YesNo If NO please explain Are/were your pets current on heartworm preventative? YesNo If NO please explain How many hours per day are you away from home? This information is useful in determining an appropriate match between dog and family. Where in the home will the dog stay if you are away for several hours? Where will the dog spend most of its time? Do you have a fenced yard? YesNo Please describe your fence. If you do not have a fence, how do you plan to keep your dog safe and exercise your dog? Describe the general level of activity of your household (for example, family size, seniors, meetings, social events) Ages of children in the home or visiting frequently Have you ever adopted from a shelter, humane society or rescue group? YesNo If so, please provide the name and location. What circumstance(s) might cause you to return the dog to TDF? Are you familiar with the possible condition(s) typical of senior dogs such as arthritis, incontinence, loss of hearing / sight? YesNo Two references who know your love of animals Phone (day/evening) Phone (day/evening) What are you looking for in a dog? Age (range) Color Sex Physical Qualities Personality Qualities Is there a specific dog that you are interested in meeting? Will you consider a dog with health needs (if so, which ones)? I understand that in the event of my/our illness, incapacitation, or death, Top Dog Foundation may take possession of the dog(s) involved in this adoption, in communication with an emergency agent named above. Top Dog Foundation will act to ensure the best possible care and outcome for the dog(s) including temporary foster care or placement in a new permanent adoptive home if there is probability that the adopter below will no longer be able to care for the dog(s). In considering a senior dog, longevity and future physical condition is difficult to project. Depending on breed, size, previous life style and treatment, and the pure will to prevail, each dog will respond differently to the “forever” new love from the new home. Do you accept that the joy given and shared by your adoption of the dog surpasses any sadness should the dog’s lifespan or quality of life prove less than most dog owners would expect?