Foster/Volunteer

Please complete this form to apply to be a Volunteer or Foster Home.

If you are interested in becoming a foster parent, you must be at least 18 years of age or older.

Should you receive an invalid error message upon submitting this form, please go back through and fill out any missed questions. You will be contacted within ten days of receipt of your application to let you know we have received and are processing it.

If you would prefer to submit your application offline, please use this form.

Contact Information

Today's Date (mm/dd/yy):

Full Name:

Spouse/Partner's Name:

Email:

Home Phone (or cell if no land line):

Cell Number:

Work Number:

Best Time to Call:

Can You Be Contacted at Work? YesNo

Home Address:

City:

State:

Zip Code:

How did you hear about MWBTR?

Family Information

Number of adults in the home:

Number of children in the home (or frequent visitors) and ages:

If you don’t currently have children, do you plan on having children in the future? YesNoNot Sure

If you have children, have they been taught how to behave around dogs and that animals deserve to be treated with respect? YesNoN/A

Your Occupation and Employer:

(Spouse/Partner) Occupation and Employer:

Are you a college student? YesNo

Are you in the military? YesNo

Have you or any members in your household been convicted of a crime against animals? YesNo
If yes, please explain:

Areas of Volunteer Interest

Please check all that apply:
FosteringFundraisingHome VisitsPhone CallsTransport DogsShelter Pulls
Other:

Personal References

Please list three personal references, not living with you. Include NAME, PHONE, & EMAIL address.

Reference 1:
Reference 2:
Reference 3:

Please inform these individuals that we will be contacting them.

Home & Property Information

Please select the style of your home: Single Family HouseDuplexCondoTownhouseApartmentMobile HomeOther
Other:

How long have you been at this address?

If you rent or lease, have you confirmed with the landlord that pets are allowed? YesNoN/A

If you rent or lease please supply the following
Landlord Name:
Address:
City/State/Zip:
Phone Number:

Please email a copy of your lease agreement to mwbtr.bostons@gmail.com

If your yard is fenced, please describe the area and type of fence:

If you do not have a fenced yard, what arrangements do you plan to make for exercise and toilet duties?

Do you have a doggie door? YesNo

If so, does it open into a fenced enclosure? YesNoN/A

Do you have a pool or spa? YesNo

Is pool or spa fenced? YesNoN/A

What is the activity level of your household? QuietActiveModerately ActiveVery Active

Are any members of your household allergic to dog hair or dander? YesNoNot Sure

Pet Information

Please list the current and past pets you have owned.

PET 1 (Name & Breed):
DogCatMale-unalteredMale-neuteredFemale-unalteredFemale-spayedPuppyAdultSeniorCurrently OwnNo Longer OwnPassed Away
Years owned (e.g.: 1990-2001)

PET 2 (Name & Breed):
DogCatMale-unalteredMale-neuteredFemale-unalteredFemale-spayedPuppyAdultSeniorCurrently OwnNo Longer OwnPassed Away
Years owned (e.g.: 1990-2001)

PET 3 (Name & Breed):
DogCatMale-unalteredMale-neuteredFemale-unalteredFemale-spayedPuppyAdultSeniorCurrently OwnNo Longer OwnPassed Away
Years owned (e.g.: 1990-2001)

PET 4 (Name & Breed):
DogCatMale-unalteredMale-neuteredFemale-unalteredFemale-spayedPuppyAdultSeniorCurrently OwnNo Longer OwnPassed Away
Years owned (e.g.: 1990-2001)

PET 5 (Name & Breed):
DogCatMale-unalteredMale-neuteredFemale-unalteredFemale-spayedPuppyAdultSeniorCurrently OwnNo Longer OwnPassed Away
Years owned (e.g.: 1990-2001)

If you need additional space for pets, please list the above information for each pet here:

Vet Information

Please provide your current Veterinarian's information. If you do not have a Veterinarian, please provide the contact information of the Veterinarian that you are planning to use for your pet.

Veterinarian Office:
Veterinarian Name:
Address:
Telephone Number:

Is this your past, current, or future vet? pastcurrentfuture
If past or current, which of your pets are patients here?

RELEASE for veterinary reference: I, , hereby give permission for any veterinarian providing service to me/my animals to release medical information on any/all of my animals to Midwest Boston Terrier Rescue (its agents).

Electronically signed by:

My current veterinarian is: , and can be reached at (telephone) or (address)

This release is not limited to the veterinarian named above. Please let your veterinarian know we will be calling for a vet reference.

Foster Information

Please complete this information to be considered for fostering now or in the future.

Have all members of the household agreed to fostering a Boston Terrier? YesNoMaybe
If no or maybe, please explain:

Have you owned a Boston Terrier before? YesNo

If your foster dog has a housebreaking accident when you are not home, how will you deal with it?

How about when you are at home?

If your foster dog chews an inappropriate object, what will you do?

What form of discipline will you use on your dog?

If/when you foster a Boston Terrier, how much time do you think it will take for your foster dog to adjust to the family and other pets and for your pets to adjust to the foster dog?

How do you plan to introduce your foster dog to your family and other pets?

Would you be willing to take your pet to a behaviorist or trainer if necessary (i.e., if through your own efforts you were unable to train the dog or its current behavior) YesNo

Would you make the time to take your pet to participate in training/obedience, etc.? YesNo

Do you have time to exercise and play with your foster dog? YesNo

What brand/variety of dog food do you feed?

Where will the foster dog be kept during the day when you are not at home?

Where will the foster dog be kept at night?

How long will the foster dog be left alone each day?

What are your thoughts to crate training as opposed to other confinement methods?

Exercise and elimination will be: Exercise pen runChain or TrolleyLeadTotally enclosed fenced yardPartially fencedElectronic/Radio fenceLoose in unfenced yard

What will you do if your foster dog runs away (i.e., who will you call and what will you do to get it back)?

Please describe the type of dog that you would like to foster. What are the "must-have" qualities and "nice-to-have" qualities?

Do you understand that our rescue dogs are not all perfect and most will require house training, obedience training, and training on basic manners? YesNo

Are you willing to put extra time and effort with training the dog, if necessary? YesNo

Are you willing to foster a dog with behavior problems? YesNoMaybe, depends

If so, what behavior are you willing to work with? (Check all that apply)
HousebreakingDiggingBarkingJumperLeash TrainingDoesn't like DogsDoesn't like CatsSeparation anxietyStool eatingMust be only petNippingBitingDoor Guarding

Are you willing to foster a dog with health problems? YesNo

If so, what kinds of health problems are acceptable? (Check all that apply)
AllergiesArthritisBlindnessDeafnessHair LossHeart DiseaseIncontinenceLimpingMyelinopathy (degeneration of spinal cord)Skin ProblemsThree LeggedSpinal DeformitySpecial DietSeparation Anxiety

Do you understand that we may not know about a behavior or health problem before a dog comes into rescue? YesNo

What will you do if you discover that your foster dog has a health or behavior problem once they come into your home for foster care?

Should your foster dog be: Dog FriendlyCat FriendlyKid Friendly

Will your current pet(s) accept a new dog? YesNoNot SureN/A

If yes, how do you feel they will react? FavorablyDifficult AdjustmentIndifferentDon't know

How would you characterize your pet's behavior? DominantSubmissivePassiveAggressivePassive AggressiveLaid backPoliteVery SociableCouch PotatoLazyOther

Volunteer and Foster Agreements

Do you understand that Boston Terriers do not tolerate extremes in temperature and are required to be indoor dogs? YesNo

Do you understand that Boston Terriers are high energy dogs and require a lot of exercise? YesNo

Do you understand that Boston Terriers can be destructive to toys, furniture, and other things? YesNo
A bored dog is a destructive dog!!!

Do you agree that the dog will not be used as a guard dog, or dog fighting bait dog, or be used for breeding or experimentation purposes? YesNo

Do you agree that in no event will the dog be sold or given away to another person or placed in an Animal Shelter or Humane Society or turned loose to run loose. YesNo

Do you agree that the dog remains the property of Midwest Boston Terrier Rescue and you will return the foster dog to MWBTR if asked to do so? YesNo

Do you agree to properly house, feed, water, exercise and care for and provide inoculations, heart worm care and other veterinary or supportive care as the dog requires, understanding the MWBTR will pay for veterinary costs only as described in the Foster Home Guidelines? YesNo

Do you agree to exercise proper control and restraint over the dog at all times and will not allow the dog to run at large? YesNo

Do you agree to have a collar and identification tags on the dog at all times, even if the pet stays indoors? YesNo

Add any additional comments that you'd like us to know more about here:

By completing and submitting this application, I/We understand that this application is only an interviewing tool, and my submission of this application in no way guarantees the placement or availability of a Boston to my family for fostering nor approves me to volunteer. YesNo

I understand that my application will be reviewed by the Midwest Boston Terrier Volunteer/Foster Committee and will be notified by email or telephone of any questions, concern, and/or decision to approve or deny my volunteer/foster application. YesNo

If/when your application in approved you will be contacted by a representative of Midwest Boston Terrier Rescue.

We reserve the right to refuse any applicant for any reason and the right to inspect the prospective home environment both before and after the approval of this application, without any advanced notice if any MWBTR dogs will be on the premises.

If we discover that any information on this form was knowingly falsified, it will be denied. Further, if any information is knowingly falsified, and the transfer of the dog has taken place, we reserve the right to take the dog back into our possession.

Electronically signed by (required):

Electronically signed by (if more than one applicant):

PLEASE REMEMBER TO FILL IN ALL FIELDS, OR YOUR APPLICATION WILL NOT GO THROUGH.