Name:

Address:

City:

State:

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip:

E-Mail:

Phone:

()    

Interest:

Foster animals in your home
Assist with home checks for prospective adopters
Transport animals
Place fosters in approved homes

Why do you wish to assist Chihuahua Rescue, USA?:

Do you presently care for/own any pets?:

Yes  No

If dogs are present, are they currently spayed/neutered?:

Yes  No No dogs

Are children living in the household?:

Yes  No

Do you own or rent?:

Rent  Own

What type of residence do you have?:

House  Condo Apartment Other

What type of fence, if any, do you have?:

Chainlink  Wood Vinyl No fence

Have you fostered dogs before?:

Yes  No

Where will fostered dogs be kept while you are away?:

Will you allow for prospective adopters to visit the dog at your home?:

Yes  No

Will you assume financial responsibility for the day-to-day care required for fosters?:

Yes  No

Will you transport fosters to a vet for spay/neuter at our expense?:

Yes  No

Will you be able to perform preliminary homechecks and post adoption checks for fosters?:

Yes  No

Will you ensure that all paperwork is completed and returned and payments forwarded in a timely manner?:

Yes  No

Please provide the name and contact number for your current vet:

Submit