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Saving resouces saving lives thomas2 Saving resouces saving lives thomas2 Document Transcript

  • Motley Zoo Animal Rescue • Foster Application • Canine • Page 1 of 7 Welcome to the Motley Zoo Animal Rescue (MZar) Foster Program. Our dedicated fosters are the backbone of our organization. Without fosters, we are unable to save these animal in need. Completing this application accurately and completely is the best way to assure a positive experience for both you and the animal. This form and a consultation with an MZar representative are designed to help match you with the most suitable foster animal. By applying, you are under no obligation to foster an animal, nor is Motley Zoo Animal Rescue under any obligation to place an animal within your care. Additional orientation, training and approval may be required. To be considered as a dog foster, you must:  Be 21 years of age or older.  Have no child living in your household under the age of 5 years.  Provide identification showing your address, or proof of residence (copy of lease and/or utility bill, for example).  Provide front and back photos of your home as well as photos of your yard, fencing, and house number.  Have the knowledge and consent of your landlord and all household members, both of which will be confirmed.  Be able and willing to spend the time necessary to provide proper care of the dog.  Understand that all dogs, no matter the size or breed, must be indoor animals and never left outside unattended.  How did you hear of Motley Zoo Animal Rescue?  Have you previously applied to Motley Zoo Animal Rescue with interest to adopt or volunteer? Yes No If yes, when?  ~ APPLICATION INSTRUCTIONS—PLEASE READ ~  Application is an interactive form: Type answers in the gray answer boxes. Once completed, save form to your desktop, attach it to an email and send to foster@motleyzoo.org, along with photo/ copy of utility bill or other proof of residence, front and back photos of your house, any fencing, and photo of your house number. The best way to ensure a speedy application approval is by electronically submitting a thoroughly completed application. Missing or incomplete information can delay or prevent approval. We have the ability to process emailed applications more efficiently than we can faxed or mailed applications. If you are having trouble with this form or have any questions, please contact us. We are here to assist you! PERSONAL INFORMATION Last name: Today’s date: First name: Spouse / Partner: Street address: City: Email: Alternate email or email comments: State: Zip: Home phone: Cell phone: Work phone: Best time to reach you: Occupation: Employer: Date of birth: Driver’s license number: Home phone: Cell: Emergency contact name: Who will provide primary care for the foster? His/ Her age? How many adults reside in your home? What are their ages? How many children reside in your home? Do children visit your home? Yes Work: Gender? What are their genders? What are their ages? No How often? What are the ages of visiting children? Are you planning to have and/or adopt a child in the near future? Yes Does everyone in your household agree to fostering a rescue animal? Does anyone in your household have pet allergies? Yes No Yes No Maybe Please explain: Don’t know No Don’t know If yes or don’t know, please explain: HOUSING INFORMATION How long have you lived at your current residence? In what type of housing do you live? House Do you have plans to move? Condo Townhome Apartment Yes Mobile No Boat/ House Boat Other, explain: Do you own or rent? Own Rent Lease to own Live with parents Other, please explain: If you do not own, do you have permission from your landlord or the homeowner to foster a pet? Landlord’s Name: Phone number: Yes No Email: Comments: Do you have a pool? Yes No Male If yes, is there a fence around the pool? Please describe: Motley Zoo Animal Rescue • info@motleyzoo.org • www.motleyzoo.org 23316 NE Redmond Fall City Rd PMB #522 Redmond WA 98053-8376 • (206) 453-8480 Female
  • Motley Zoo Animal Rescue • Foster Application • Canine • Page 2 of 7 Do you have a completely fenced yard? Yes No Partially fenced What kind of fence? Height of the fence: If you do not have a completely fenced yard, please describe how you plan to exercise a dog safely: Are you willing to have an MZar representative inspect where the foster animal will be living? Yes No ENVIRONMENTAL INFORMATION Do you work outside the home? Yes No Will the animal be kept home alone while you are at work? Will the animal be alone for 4 or more hours at a time? Yes No Where will the animal be kept during the day? Yes No If yes, where will the animal be kept? At night? Are there times when the animal will be tied up or left outside in a kennel? Will the animal spend any time in the garage? Yes No Yes No If yes, when and how long? If yes, please describe: Do you understand that all dogs need daily walks outside the home and yard for their mental and physical well being? Are you able and willing to exercise the dog on a daily basis? Yes No If you drive a pickup truck, would you allow the dog to ride in the back? Yes No If yes, method of exercise: Yes No NA Do you have a canopy? Yes No Do you understand and agree that you MUST obtain prior approval from your MZar foster coordinator if anyone other than a MZar representative is to care for your foster animal(s) while you are on vacation or otherwise away from your home? Yes No PET HISTORY Do you have any pets in your household? Name Yes Breed / Type of Pet No If yes, please complete the following for ALL pets in your household. Gender Age Spayed / Neutered? Male Female Yes Male Female Yes No Male Female Yes No Male Female Yes Comments No No Are your dogs / cats indoor or outdoor pets? Explain: Is your cat(s) declawed? Explain: If any of your pets are not spayed or neutered, please explain: Are all your pets current on their applicable vaccinations? Yes If you have pets, will they adjust to a new foster in the house? Is your dog(s) obedience trained? Yes Have you owned any other pets in the past 10 years? Name Breed / Type of Pet No Yes No If no, please explain: Don’t know No Please explain: Please explain: Yes No Gender If yes, please complete the following for all other pets owned. Age Spayed / Neutered? Male Female Yes Female Yes No Male Female Yes No Male Female Yes Where is the pet now? No Male Date, if deceased. No Have you ever surrendered an animal to a shelter/ rescue/ friend/ relative, or to any other party for any reason? Yes No If yes, please explain: For what reason(s) would you request we remove a foster from your home? (check all that apply) Moving Divorce Allergies Behavioral challenges Shedding Too long of a stay in foster care New baby Barking / Whining Not getting along with other pets Energy level of the animal Work or other commitments limiting your time with the animal Housebreaking challenges Chewing of personal items Escaping from home or fence Children lost interest Too time consuming Medical issues in the animal Other, please explain: Do you agree that for ANY reason a Motley Zoo Animal Rescue Animal DOES NOT work out, you will immediately notify your MZar foster coordinator and RETURN the Animal immediately and safely to an MZar representative? Yes No HEALTH HISTORY Motley Zoo Animal Rescue • info@motleyzoo.org • www.motleyzoo.org 23316 NE Redmond Fall City Rd PMB #522 Redmond WA 98053-8376 • (206) 453-8480
  • Motley Zoo Animal Rescue • Foster Application • Canine • Page 3 of 7 We will contact your veterinarian to confirm ALL your pets’ vaccinations and spay / neuter status. Please provide multiple vet information if needed. Without contact information for your veterinarian(s)*, we are unable to process your application. If your pets have passed away, please provide your prior vet information. If you do not own pets, please select a vet in your area that you will use for your new pet and provide the contact information. We are not able to proceed without vet information. Contact us with any questions. Thank you for your understanding and cooperation! * For multiple vet information, please provide primary vet information below and additional vet information in your email. Vet Clinic: City: Phone number: State: Comments: Do you realize that all dogs can shed 365 days a year and that longer-coated dogs are higher maintenance and require regular grooming for the health of the animal, not just for vanity? Yes No If you own any pets, will you keep them current on all vaccinations at all times while fostering for MZar? Yes No What is your knowledge and personal experience with dog health problems? Please explain: Are you willing to administer daily medication, should a health condition of your foster dog require? Would you be willing to foster a special needs dog? Yes Yes No No BEHAVIORAL EXPERIENCE What experience do you have with dogs and length of time of experience (companion pet, agility, trainer, showing, breeding, etc…)? Why do you want to foster a rescue animal and how are you prepared to meet their special requirements? What experience do you have with animal behavior issues and how did you resolve them? Are you willing to help your foster dog become more adoptable by working on their leash training, household manners, greeting manners, etc? Are you willing to foster a dog with behavioral issues, with the guidance and support of a professional trainer? Yes No If yes, please explain what behavioral issues you would be willing to assist: Are you willing to work at housebreaking a foster dog if necessary, to help it become more adoptable? Yes No Do you understand that even housetrained dogs require a transition period during which they may have a few accidents as they adjust to your new living situation and schedule and are you willing to work through this adjustment period? Yes No Do you have experience with crate training? Please explain: If your foster dog is not housebroken, what method will you use to train him/her? FOSTER PREFERENCES Please describe your foster dog preferences. Size (check all that apply): Breed: Explain your experience with this breed: Gender: Male ONLY Age (check all that apply): Female ONLY Puppy Either Young Adult Small Medium Large Any Explain: Adult Senior Explain: The average dog is in foster care for approximately 2 weeks - 2 months. Are you able to foster a dog for this length of time? Yes No If not, what is the length of time you are willing to foster? What activities are you looking to enjoy with your foster? What other type(s) of animal(s) might you be willing to foster? (check all that apply) Guinea pig Hamster(s) Bird Turtle Lizard Kitten Goat Cat Horse Bunny Ferret Other: REFERENCES Full Name: Relationship: Street address: Phone: Full Name: Street address: Number of years known: City: Email: State: Zip: Comments: Relationship: Number of years known: City: Motley Zoo Animal Rescue • info@motleyzoo.org • www.motleyzoo.org 23316 NE Redmond Fall City Rd PMB #522 Redmond WA 98053-8376 • (206) 453-8480 State: Zip:
  • Motley Zoo Animal Rescue • Foster Application • Canine • Page 4 of 7 Phone: Email: Comments: Please read the following carefully and in its entirety, to be initialed, signed, and dated by the Volunteer at time of acceptance and in witness of an authorized Motley Zoo Animal Rescue representative. Motley Zoo Animal Rescue is a Washington State non-profit 501(c)(3) corporation. In this Agreement, Motley Zoo Animal Rescue may also be called “MZar.” TERMS OF FOSTERING The Foster represents that the information provided in the application process is true and complete to the best of the Foster’s ability and belief. Motley Zoo Animal Rescue and the Foster wish to enter into this Agreement to provide the Animal with a temporary home. 1) Professional Presence. Sometimes people can be difficult, but it is important for volunteers and staff to maintain a polite and professional attitude whenever they are representing the organization. Even if another person is being unreasonable, unpleasant confrontations should be avoided. If a problem arises, please let your supervisor know as soon as possible. I agree: Initial Date 2) Personal Opinions and Organizational Policy. When you are representing the organization in public, people have a tendency to perceive everything that you say as the official policy of the organization, even though this may not be your intention. Please take care not to represent any of your personal opinions in such a way that people might interpret them to be the policy of the organization. If anyone asks you a question about our policies that you cannot answer with certainty, always reply that you will check into it and get back to them. This answer is also appropriate if you are talking with the media. I agree: Initial Date 3) MZar Materials. Do not customize or otherwise alter MZar flyers, documents, posters, presentations, or other materials. If you would like to create materials for the organization, please seek approval before you begin work on the project. This will help avoid duplication of effort and time spent on something that cannot be used at this time. I agree: Initial Date 4) Public Comments. If you would like to write a letter to the editor or an article on behalf of the organization, please contact our executive director. Do not write letters or otherwise represent the organization without obtaining expressed, advance approval from our executive director. Do not make public statements that are critical of other organizations. Statements about other organizations need to be approved by our executive director. I agree: Initial Date 5) Commitments. Unless you have been authorized to make a specific decision, do not make commitments for the organization, including offers of assistance or promising a pet to someone. I agree: Initial Date 6) Fundraising. We always welcome assistance from volunteers and members with spreading the word about the organization and our programs. One way to do this is to distribute literature about the organization to friends, family and neighbors. If you would like to help in other ways, please confer with our executive director or operations director. Obtain approval before soliciting donations, as we need to avoid duplicate requests, ensure that requests are appropriate (some funding sources may be controversial), obtain any required permits, and appropriately acknowledge all donations. I agree: Initial Date 7) In-kind Donations. It is important that all donations be used in the manner in which they are intended and we are legally responsible for documenting this, even if the donation is modest in size. We also want to acknowledge all donors and keep in touch with them through our alerts and emails. All donations must be reported to the executive director in writing, including the name of the donor and a listing of items, their estimated value, and their disposition. Example: “July 1, 2009: 2 cases of dog food donated by Sally Smith, 101 Main Street, Seattle, WA 98119; est. value $15; used to feed rescue animals in foster care.” We will document the donation and send an official acknowledgment to the donor. I agree: Initial Date 8) No-kill Policy and Euthanasia. MZar is a no-kill humane organization. We do not euthanize healthy animals. We do practice euthanasia in the true sense of the word, “to end suffering of a critically ill or injured animal or as a last resort in the case of a dangerously aggressive animal.” Such a decision is made in consultation with a veterinarian and, when appropriate, an animal behaviorist. Euthanasia is always administered in the most painless method available by a licensed veterinarian. The Foster agrees and understands that not all animals may be saved and such a decision is the ultimate responsibility and authority of MZar’s Board of Directors. I agree: Initial Date 9) Admitting Animals. Unfortunately, we cannot take in every animal, though we wish we could. At this time, we have limited resources, space, and volunteers. These factors limit the number of animals for which we can properly care. To take in even one more animal than we can provide care for would be irresponsible and unfair to the animals. When possible, we try to accommodate the requests of our volunteers and members. If we are unable to meet your request, please understand that we also receive hundreds of requests for help each week from the public, many involving animals in dire need of our help. We strive to prioritize care so that the neediest animals receive our attention first. Sadly, we are unable to help them all at this point. We maintain a waiting list of animals in need of shelter and veterinary care. Your foster support enables us to help growing numbers of animals and address the core issue that affects companion animals: overpopulation. I agree: Initial Date Motley Zoo Animal Rescue • info@motleyzoo.org • www.motleyzoo.org 23316 NE Redmond Fall City Rd PMB #522 Redmond WA 98053-8376 • (206) 453-8480
  • Motley Zoo Animal Rescue • Foster Application • Canine • Page 5 of 7 10) Policies and Procedures. Organizational policies and procedures are established by the Board of Directors. Decisions regarding the day-to-day operation of the organization are under the authority of our executive director, operations director, and designated program managers. This includes, but is not limited to, such matters as accepting animals into our care, euthanasia, fundraising methods, approving financial expenditures, exceptions to standard procedures, and all other operational matters. Volunteer input is always appreciated. We recommend that you address comments on policies, procedures, and decisions to our executive director or operations director. I agree: Initial Date 11) Compensation. As a volunteer it is important that you understand that the organization will not be compensating you for your time or work. I agree: Initial Date 12a) Animal Ownership. The Foster agrees that if he or she is unwilling or unable to care for the Animal at any point during the foster care, the Foster will contact MZar and return the Animal to a location specified by MZar. The Foster understands that he or she is responsible for the care of the Animal until he or she has delivered the Animal to an authorized MZar representative, and will do everything within his or her control to safely return the Animal. I agree: Initial Date 12b) Animal Ownership. The Foster agrees that in the event the Foster finds a suitable permanent home for the Animal, the Foster will contact MZar with the name, address and phone number of the proposed adopter. Any proposed adopter, including the Foster, will be required to complete an MZar adoption application and other requirements for adoption and obtain approval from MZar, in writing, before adopting the Animal. Under no circumstances shall the Foster transfer permanent custody, ownership or possession of the Animal, to any entity, including family, friends, or an agency, without the approval and written consent of Motley Zoo Animal Rescue. I agree: Initial Date 13) Veterinary Care. Veterinary care that has already been approved by MZar will be provided by MZar, unless otherwise indicated by the Foster in the case of sponsorship, wherein the Foster may choose to fund certain necessary veterinary care for the Animal. This includes, but is not limited to vaccinations, dental care, altering, deworming, flea treatment, microchip, and prescribed medications deemed necessary for the Animal by an MZarapproved veterinarian. The Foster, regardless of sponsorship status, agrees to obtain prior approval from Motley Zoo Animal Rescue before taking the Animal to a veterinarian clinic prior to any treatment. This is to prevent unnecessary or duplicate expenses. In addition, MZar has a Veterinarian Network with which they have a trust base, discounted services, and payment plan options. The Foster agrees to notify an MZar representative promptly, should the Animal become sick or injured, and in the case of an emergency, attempt to contact an MZar representative to coordinate immediate veterinary care. Should the Animal need emergency care and all MZar representatives are unavailable, the Foster agrees to do everything within the Foster’s power to safely transport the Animal to an MZar Veterinarian Network clinic and have the clinic stabilize the Animal until a MZar representative is contacted to further consult with the veterinarian, regarding the care of the Animal. Under no circumstances shall the Foster agree to or allow the euthanasia of the Animal as required in this agreement. I agree: Initial Date 14) Expenditures. Expenditures incurred by the Foster, other than emergency care and treatment, require prior approval by MZar. The Foster will be held responsible for any and all unapproved expenditures. I agree: Initial Date 15) Care of the Animal. The Foster understands that the Animal is an indoor pet and agrees to allow it access to the home. The Foster agrees to never leave the Animal unattended outside and to have the Animal on a secure leash while traveling or while outside when not in a secured yard. The Foster agrees to provide the Animal with fresh water, wholesome food, adequate exercise, training guidance, and loving attention. In addition, the Foster agrees to allow an MZar representative to examine the Animal at any point during foster care, for any reason, including the living conditions and to return of the Animal if the condition of the Animal, environment, and/or level of care is deemed unsatisfactory. The Foster further agrees to never take the Animal to a dog park without the written consent of an MZar representative. This is for the safety of the Foster, Animal, and the public. I agree: Initial Date 16) Meet & Greets Protocol. The Foster agrees, prior to all Meet & Greets with potential adopters or events, to bathe and provide general grooming of the Animal, such as clipping nails, cleaning ears, and to fit the collar and leash appropriately on the Animal. The Foster further agrees to notify MZar of any and all health or behavioral observations new to the Animal, prior to arriving at the Meet & Greet location. I agree: Initial Date 17) Behavioral Issues and Training. The Foster agrees to immediately notify MZar of any behavioral issues observed in the Animal, including but not limited to housebreaking status, jumping, barking, chewing, growling, biting, or any signs of stress, distress and/ or aggression in the Animal. The Foster further agrees to consult their MZar representative prior to the use of any training tools or techniques. Under no circumstance is a Foster to utilize the following training techniques or tools, without the direct supervision of an MZar approved licensed animal behaviorist or licensed animal trainer: alpha rolling, shock collars, choke collars, pinch collars, and citronella spray collars. This is for the protection of both the Foster and the Animal and for which MZar holds a no-tolerance policy. Additionally, MZar requires all Fosters have a properly fitted crate available, should it be necessary. If the Foster does not have a properly fitted crate available, the Foster agrees to notify MZar and MZar will promptly provide one for the Animal. I agree: Initial Date 18) Evaluation. MZar requires the Foster to perform an informal evaluation of the Animal’s observed needs and personality, with updates provided by the Foster. The Foster agrees to informally evaluate the Animal and provide MZar with a completed evaluation form, detailed to the best of the Foster’s knowledge and ability. This evaluation form may be kept with the adoption package as information for the new owners. Please request MZar’s Animal Biography form. This form will additionally be used to help create the Animal’s PetFinder profile and answer any questions prospect adopters may have of the Animal. Motley Zoo Animal Rescue • info@motleyzoo.org • www.motleyzoo.org 23316 NE Redmond Fall City Rd PMB #522 Redmond WA 98053-8376 • (206) 453-8480
  • Motley Zoo Animal Rescue • Foster Application • Canine • Page 6 of 7 I agree: Initial Date 19) No Representations. The Foster understands that MZar does not guarantee the health, temperament, housebreaking or training of any Animal. I agree: Initial Date 20) Local Regulations. The Foster agrees to obey any and all animal control regulations governing the area in which they live. I agree: Initial Date 21) Seizure and Impoundment of the Animal. If the Animal shall, for any reason, be confiscated by local law enforcement or Animal Control, the Foster will immediately contact MZar by phone or email that the Animal has been impounded and provide the Animal’s location. The Foster shall also inform the authorities that the Animal is under the ultimate ownership of MZar, is microchipped, and provide contact information for MZar, requesting that the authorities contact MZar immediately. Under no circumstance will the Foster agree to or allow the euthanasia of the Animal as required in this agreement. I agree: Initial Date 22) Lost Animal. The Foster will contact MZar immediately if the Animal becomes lost. Further, the Foster agrees to notify local veterinarian offices, shelters and Animal Control. To these parties, the Foster agrees to provide a complete, accurate description and pictures of the Animal. In addition, the Foster agrees to assist in executing the recovery plan as best they are able, including posting flyers within a two mile radius of where the Animal originally escaped, keeping an open crate with a blanket, food, and water on the Foster’s porch, and leaving the yard gates open so that the Animal has the ability to return. I agree: Initial Date 23) Release. The Foster further agrees to accept all responsibility for any harm caused by the Animal to humans, other animals, or personal property in connection with fostering a rescue animal, including, without limitation, any damages resulting from bites, scratches, or any other form of aggression, and any damages resulting from the Animal’s failure to become housebroken. I agree: Initial Date 24) Indemnity Agreement. The Foster, and for his/her spouse, heirs, executors, personal representatives, and assigns, agrees to indemnify and hold Motley Zoo Animal Rescue harmless for all bodily injury, personal injury, illness, amputation, scarring, death, property damage or other losses, including attorney’s fees and costs of litigation, that result to anyone else or any other entity because of the Foster’s negligence or liability. This includes lone acts or omissions by the Foster as well as the combined acts of the Foster with others. I agree: Initial Date 25) Change of Address. In the event that the Foster moves, the Foster agrees to contact MZar with change of address information, so that all records can be updated. If applicable, landlord and household member approval will be reconfirmed and environmental details will be reviewed to ensure proper placement of the Animals into foster care. I agree: Initial Date 26) Other. The Foster expressly agrees that the Release (23) and Indemnity Agreement (24) are intended to be as broad and inclusive as permitted by law. The Foster agrees that in the event that any clause or provision of this Agreement shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this agreement. This is the entire agreement between the parties and supersedes any other verbal or written statements, representations, or promises. This agreement shall be governed by and interpreted in accordance with the laws of the State of Washington. Any disputes under this agreement will be resolved in King County, Washington. All disputes under this agreement will be settled by binding arbitration. I agree: Initial Date 27) MZar Privacy. All information specific to MZar and its volunteers is not to be shared with anyone outside the organization. All inquires into the organization will be referred to MZar’s executive director. I agree: Initial Date The Foster agrees that he or she is 21 years of age or older and legally competent to enter into this Agreement, and this Agreement is binding upon the heirs, assigns, successors, personal representatives and executors of both parties. _______________________________________________ __________________________ Signature of Foster Printed Name of Foster Date _______________________________________________ __________________________ Signature of Motley Zoo Animal Rescue Agent Printed Name of Agent Date Motley Zoo Animal Rescue • info@motleyzoo.org • www.motleyzoo.org 23316 NE Redmond Fall City Rd PMB #522 Redmond WA 98053-8376 • (206) 453-8480
  • Motley Zoo Animal Rescue • Foster Application • Canine • Page 7 of 7 CONFIDENTIAL Motley Zoo Animal Rescue • info@motleyzoo.org • www.motleyzoo.org 23316 NE Redmond Fall City Rd PMB #522 Redmond WA 98053-8376 • (206) 453-8480