If there are children in the home what ages are they?
Choose all that apply:
Yes
No
What are the ages of the children? *
Work Phone
Do you work? *
Choose one:
Yes
No
Attend school? *
Choose one:
Yes
No
Employer/school name *
Do you rent or own? *
Choose one:
Rent
Own
Birthdate of foster
Describe the ideal dog for you (and/or your family). What personality, disposition, energy level or general traits would make up the ideal dog to suit your current lifestyle? And list from the most important to the least important.
Example- we take our dogs to the dog park. That will let us know the dog you are looking for Must be able to go to a dog park with unknown dogs.
Example- We have many different children over or we do child care in the home. That tells us that the rescue dog must be able to function in that type of environment? *
In what type of home do you live *
Choose one:
Single Family
Duplex
Apartment
Townhouse
Condominium
Mobile Home
Military Housing
Is your yard fenced *
Choose one:
No Yard
Unfenced Yard
Yard Partially Fenced
Yard Completely Fenced
What is the height of the fence *
What type of fence *
Choose one:
Privacy
Chain Link
Invisible
Have you participated in rescue before? *
Choose one:
Yes
No
If you have participated with rescue groups in the past, what groups?
What type of experience do you have, if any, in rescuing animals? *
Why do you want to become involved in rescue? *
If you have been doing rescue independently, how long have you been doing so? What was your fee structure? How many dogs have you placed? Have you used contracts at all?
If you have a spouse or live in partner, how does that person feel about your involvement in any type of rescue participation? *
Have you ever been convicted of a felony or misdemeanor involving mistreatment of animals or children? *
Choose one:
Yes
No
Please indicate the ways you would be willing and able to participate?
Fostering *
Choose one:
Yes
No
Bailing out of shelters *
Choose one:
Yes
No
Evaulating the animal *
Choose one:
Yes
No
Are you willing to transport animals? *
Choose one:
Yes
No
Making phone calls to set up transportation runs *
Choose one:
Yes
No
Making phone calls to check references *
Choose one:
Yes
No
Do home checks *
Choose one:
Yes
No
Public Relations (such as placing ads, working rescue booths, etc.) *
Choose one:
Yes
No
Fund-raising *
Choose one:
Yes
No
Other ways you may want to participate
Briefly explain your history or involvement with the breed. How long? How many have you had? What happened to them? *
Have you ever completed an obedience course? Did the class use a choke collar? Clicker training? Treats or other positive reinforcement? Do you or can you provide basic training (socializing, leash breaking, etc.) of rescues? *
How would you go about potty training a dog? *
Do you have any experience with aggresive or scared dogs? *
Choose one:
Yes
No
Are there areas of specialty that you would like to undertake in rehabilitating a dog such as aggressiveness, potty training, socialization, allergies, heartworms, holistic practices, and so on? If so, which ones are you already skilled in versus those you would need training in order to do?
Are you involved in any dog sports, dog assisted therapy, conformation showing, protection work, field events, earthdog, obedience, agility or other special activities? List if so
Do you believe in spaying or neutering? Why or why not? *
Have you ever bred dogs in the past? Present? Why or why not? *
If yes what is your stance on breeding, health checks, frequency, etc.?
If not, do you have any breeding experience? *
Choose one:
Yes
No
What are your views on puppy mills and back yard breeders? *
What is your opinion regarding euthanasia putting dogs to sleep)? *
Are you willing to transport dog? If so, what mile radius from your home? *
Are you willing to check your local area shelters on a regular basis for dogs? If yes, please name the shelters to avoid duplications. *
Do you feel competent to identify the different mastiff breeds? *
Choose one:
Yes
No
Do you feel competent to distinguish between a mix and another breed that the shelter might try to talk you into taking? *
Choose one:
Yes
No
If fostering, how many dogs can you foster at one time? *
How long could you keep a foster dog? *
Where would you keep your foster dog? *
What would you feed the foster dog? *
Do you have an exercise program for your dogs and/or the foster? *
Do you have a separate place to quarantine or to keep dogs separate in the case of dog aggression? *
Choose one:
Yes
No
Do you have any other pets in your home, dogs, cats? *
Choose one:
Yes
No
If so please list there breed, age, name and if they are spayed or neutered *
Has your current pet ever lived with other animals before?
Choose one:
Yes
No
If you have pets, how would you introduce the rescue dog?
How many hours a day would the foster be without human companionship? *
Have you given consideration to how hard it is to place a foster dog when the time comes? This is in regard to your attachment to the foster. *
Choose one:
Yes
No
Who referred you to Canine Rescue Coalition? Or how did you find out about Canine Rescue Coalition? *
Are you able to do home checks of potential adopters in your area? *
Choose one:
Yes
No
Provide three personal references who can attest to your interest, interaction, feelings about animals in general and dogs in particular.
Please list their name, relationship to you, phone number, address, city, state and zip code. *
If you have pets or have had pets in the past, please provide a vet reference. Name, phone, address, city, state, and zip code.
The Canine Rescue Coalition is a 501c 3 corporation and therefore has policies and procedures that must be followed.
Every dog is spayed/neutered before the adoption.
The rescue must be on heartworm prevention year round.
The rescue dog must have an annual vet visit to include rabies, boosters, examination, and heartworm test.
Volunteers accept liability for personal injury or damages caused by a rescue dog. You may wish to consult your insurance agent with any concerns.
By submitting this application for consideration, you agree to abide by the policies and procedures of Canine Rescue Coalition.
By typing my name and date below, I certify the information provided by me is true to the best of my knowledge and I recognize that any misrepresentation of that information will result in my losing my privilege of being officially associated with Canine Rescue Coalition. I understand that this application will remain the property of Canine Rescue Coalition. *
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