Shiba Inu Rescue Association (SIRA)

First Name:

Last Name:

Age:

Occupation:

Email:

Spouse/Partner's First Name:

Last Name:

Age:

Occupation:

Email:

Address:

City:

State:

Zip Code:

Nearest Large City:

Home Phone:

Other Phone:

List all other adult members in the household. Include names, ages, occupations and relationships to you:

Are there children in your household?

If yes, please provide names and ages:

Who will be the primary cartaker of the foster dog?

Have you owned a Shiba Inu before?

If yes, what do you like most about owning a Shiba?

What do you like the least?

Is the Shiba still residing with you?

If not, please explain:

How do your current pets get along with new dogs? Please be specific:

How and when will the foster dog be exercized?

Type of fence:

Height of fence:

If yes, is it securely fenced?

Do you have a yard?

Would you ever consider moving to a place that does not allow pets?

If yes, please list:

Are you planning to move in the next 10 years?

If yes, please list:

Have you moved in the past 10 years?

Weight/breed/number of pets restrictions:

Phone Number:

If renting please provide your landlord's name:

If other, please explain:

What is your current living arrangement?

Does anyone in your household have pet-related allergies?

What is the activity level of your household?

Where will the foster dog stay during the day?

If other, please describe:

Are you aware that all rescue dogs experience a period of adjustment after entering their foster home, during which time the dogs may exhibit undesirable behaviors, including but not limited to: potty accidents, marking, chewing and digging?

If the foster dog makes a mistake (potty accident, chewing, aggression, etc.) please explain how you would correct the behavior:

Do you have experience training a dog?

If yes, please explain:

Preferred gender:

What activity level(s) would you would prefer?

(Hold ctrl for multiple selections)

Please explain your preferences:

Would you consider fostering something other than your selected preferences?

Would you consider fostering a special needs dog?

Would you consider fostering an older dog?

Would you consider fostering a Shiba mix or Jindo mix?

How far are you willing to travel to pick up your foster dog?

Select all ages you would consider fostering:

**Please keep in mind there are very few puppies in rescue**

(Hold ctrl for multiple selections)

Please provide your veterinarian's name:

Phone number:

Do you need recommendations for veterinarians in your area?

Please provide two non-related references, that do not reside in your home for us to contact. These should be people that have been around your pets or are familiar with your pet experience. If this is not possible (ie you have never owned pets or have not owned any for many years) than you may provide references who are unfamiliar with your pet experience, but know you well.

Any other information or comments:

Have you ever given away an animal or surrendered one to a shelter/rescue group?

What do you like the least?

Please list all the pets you have owned, beginning with the current or most recent pets:

Why are you interested in fostering a rescued Shiba Inu?

If you have NOT owned a Shiba Inu before, please explain how you learned about the breed:

If yes, please explain:

Have you ever had a pet euthanized?

If yes, please explain:

Have you ever had a pet lost or injured in an accident?

If yes, please explain:

Have you ever applied to another rescue group or shelter to become a foster home?

If yes, which one(s)?

Were you approved?

If not please explain:

Preferences

References

Read and Sign

forth by Shiba Inu Rescue Association.

I certify that I, have read and agree to the above conditions as set

General Information

If you have NOT owned a Shiba Inu before, but have had another breed of dog, tell us what
breed(s) and what you like most about owning it?

List how long each adult in the household is typically away from home during weekdays:

During weekends:

If applicable, will the children in your household be expected to care for the rescue dog?

If yes, in what capacity?

If yes, please explain:

Where will the foster dog stay during the night?

I will never allow the foster dog to run off leash in a non-securely fenced area.

My foster dog will wear an identification tag at all times.

Requirements for Fostering

I understand that adoption fees range from $200-$400 depending on the dog's age.

I understand that Shiba Inu Rescue Association covers all medical care expenses while the dog is in foster care. If a medical emergency arises and I am unable to bring the dog to Glen Ellyn Animal Hospital, I will take the dog to a veterinary clinic in my area that can provide the foster dog medical care at a discounted rescue rate.

I will contact Shiba Inu Rescue Association and provide notification of any changes in contact information from what is listed on this application.

I certify that I, have read and agree to the above conditions as set

forth by Shiba Inu Rescue Association.

*Constitutes electronic signature

All references, personal, veterinarian and landlord, will be checked prior to a home visit being arranged. If you do not want want them to be contacted DO NOT SUBMIT THIS FORM. Also be sure to contact your vet immediately and give them permission to release your records to Shiba Inu Rescue Association. Failure to do so will result in a delay of the application process.

Once your references have been verified you will be contacted to arrange a home visit. This may take a few days depending on how quickly our volunteers are able to get in contact with your references. If at any point during the process you decide you do not wish to foster please send an email to adoption@savingshibas.com.

Head of household must fill out this form.
You must be at least 18 years old to apply to become a foster home.

I will keep the foster dog as a pet in my home as a part of the family. I will not keep it outdoors or leave it outside unattended for any extended length of time.

I will be responsible for attaining the required licenses in accordance with the regulations in my community/city/county/state/etc.

I will notify Shiba Inu Rescue Association if I cannot keep the foster dog for any reason. The foster dog may never be given to an individual, shelter or another rescue organization without express permission from the adoption, foster home and intake coordinators.

I will not have the foster dog euthanized or undergo any sort of elective surgery without the recommendation of a vet and written permission from Shiba Inu Rescue Association.

I understand that Shiba Inu Rescue Association reserves the right to reposes the foster dog should any portion of the adoption contract be breeched or if it is determined that the foster dog is abused or neglected in any way.

I understand that Shiba Inu Rescue Association reserves the right to deny my application at anytime, for any reason should it be determined that my home is not suitable for a foster Shiba Inu.

I understand that at this time Shiba Inu Rescue Association does not reimburse for fostering supply expenses, including, but not limited to collars, leashes, harnesses, food, bowls, treats, etc.

I have fully read, understand and agree to follow the Fostering Guidelines as set by Shiba Inu Rescue Association.