foster application

Application Error: We are currently experiencing an issue with applications. If you would like to receive an application in Word format to complete and email back to us, Please kindly send an email to bod@rpsm.org to receive your blank application. We apologize for the inconvenience.

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1PERSONAL INFO

2HOUSEHOLD INFO

3PET CARE

4REFERENCES

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Personal Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Home*

Cell

Email*

Marital Status*

Education Level*

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Household Information

Do you have family members or roommates living with you?*

YES

Number of Adults*

Number of Children*

Ages of Children*

Do all of the adults work outside the home?*

YES

Type of Dwelling*

Do you have a completely fenced in yard?*

YES

Do you own or rent?*

OWN

RENT

Rental Information

Landlord's Name*

First Last

Landlord's Phone*

Rental Length*

Prior Landlord's Name

First Last

Prior Landlord's Phone

Foster Environment

Please tell us about your home environment and your neighborhood (i.e. rural, lots of children, senior-citizen neighborhood, dog oriented neighborhood)*

Why are you interested in fostering an animal for RPSM?*

Please tell us about your experience caring for animals*

Would you be willing to care for a rescue animal that has substantial medical issues that require a heavy level of attention?*

YES

Would you be willing to care for a rescue animal that has behavioral / socialization issues which may require extra attention?*

Name of practice

Phone

Address

Street Address Address Line 2 City State ZIP Code

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Personal References

Reference #1

Name*

First Last

Address*

City State

Phone*

Relationship to this person*

Reference #2

Name*

First Last

Address*

City State

Phone*

Relationship to this person*

How did you hear about RPSM?

Other

Please upload 3 photos of your fence, if you do not have a fence show us the area the dog will be pottied in.*

Drop files here or

Max. file size: 1 GB.

Due to Covid we will need to conduct your home visit via photos. We need to see these photos in order to help you prepare for fostering an RPSM foster dog.

Please upload 2 photos of the common area where the dog will be living. We do not need to see bedrooms or bathrooms.*

Max. file size: 1 GB.

Due to Covid we need to do your home visit via photos.

Foster Release

As a member of RPSM, I pledge the following: 1. To abide by the by-laws and operating procedures of RPSM. 2. To conduct any activities related to RPSM in a volunteer capacity, receiving no compensation or substantial personal gift for it. 3. To educate potential adopters, the general public and current pet owners about issues regarding spay and neuter, I.D., temperament, health, training, care, etc. 4. To complete any RPSM volunteer activities as promptly as possible and to promptly notify RPSM leadership if unable to complete a volunteer activity. 5. To conduct myself in a courteous manner in all facets of RPSM work such that my behavior brings credit to the image of RPSM and animal rescue in general. 6. To support the spay/neuter policies of RPSM and attempt to educate the public as to the importance of spaying and neutering. I have read and fully understand the above Code of Ethics and the Bylaws of Refurbished Pets of Southern Michigan. I understand that a breach of these may result in my removal as a volunteer in good standing.*

I agree*

Name*

If you would like to be considered as a possible foster family for one of our rescued pets, please sign and date below: I HERE BY ACCEPT RESPONSIBILITY FOR ANY/ALL ILLNESS THAT CAN OCCUR FROM A TEMPORARY CARE ANIMAL. I RELEASE REFURBISHED PETS OF SOUTHERN MICHIGAN FROM ANY AND ALL LIABILITY, NOW AND IN THE FUTURE, FROM MY VOLUNTARY ACTION OF CARING FOR ANY REFURBISHED PETS OF SOUTHERN MICHIGAN ANIMAL. Typing your name will be considered a legal digital signature.

First Last

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