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?  Yes No

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?  Yes No Not Sure

If you have children, have they been taught how to behave around dogs and that animals deserve to be treated with respect?  Yes No N/A

Your Occupation and Employer:

(Spouse/Partner) Occupation and Employer:

Are you a college student?  Yes No

Are you in the military?  Yes No

Have you or any members in your household been convicted of a crime against animals?  Yes No
If yes, please explain:

Areas of Volunteer Interest

Please check all that apply:
 Fostering Fundraising Home Visits Phone Calls Transport Dogs Shelter 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 House Duplex Condo Townhouse Apartment Mobile Home Other
Other:

How long have you been at this address?

If you rent or lease, have you confirmed with the landlord that pets are allowed?  Yes No N/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?  Yes No

If so, does it open into a fenced enclosure?  Yes No N/A

Do you have a pool or spa?  Yes No

Is pool or spa fenced?  Yes No N/A

What is the activity level of your household?  Quiet Active Moderately Active Very Active

Are any members of your household allergic to dog hair or dander?  Yes No Not Sure

Pet Information

Please list the current and past pets you have owned.

PET 1 (Name & Breed):
 Dog Cat Male-unaltered Male-neutered Female-unaltered Female-spayed Puppy Adult Senior Currently Own No Longer Own Passed Away
Years owned (e.g.: 1990-2001)

PET 2 (Name & Breed):
 Dog Cat Male-unaltered Male-neutered Female-unaltered Female-spayed Puppy Adult Senior Currently Own No Longer Own Passed Away
Years owned (e.g.: 1990-2001)

PET 3 (Name & Breed):
 Dog Cat Male-unaltered Male-neutered Female-unaltered Female-spayed Puppy Adult Senior Currently Own No Longer Own Passed Away
Years owned (e.g.: 1990-2001)

PET 4 (Name & Breed):
 Dog Cat Male-unaltered Male-neutered Female-unaltered Female-spayed Puppy Adult Senior Currently Own No Longer Own Passed Away
Years owned (e.g.: 1990-2001)

PET 5 (Name & Breed):
 Dog Cat Male-unaltered Male-neutered Female-unaltered Female-spayed Puppy Adult Senior Currently Own No Longer Own Passed 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?  past current future
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?  Yes No Maybe
If no or maybe, please explain:

Have you owned a Boston Terrier before?  Yes No

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)  Yes No

Would you make the time to take your pet to participate in training/obedience, etc.?  Yes No

Do you have time to exercise and play with your foster dog?  Yes No

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 run Chain or Trolley Lead Totally enclosed fenced yard Partially fenced Electronic/Radio fence Loose 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?  Yes No

Are you willing to put extra time and effort with training the dog, if necessary?  Yes No

Are you willing to foster a dog with behavior problems?  Yes No Maybe, depends

If so, what behavior are you willing to work with? (Check all that apply)
 Housebreaking Digging Barking Jumper Leash Training Doesn't like Dogs Doesn't like Cats Separation anxiety Stool eating Must be only pet Nipping Biting Door Guarding

Are you willing to foster a dog with health problems?  Yes No

If so, what kinds of health problems are acceptable? (Check all that apply)
 Allergies Arthritis Blindness Deafness Hair Loss Heart Disease Incontinence Limping Myelinopathy (degeneration of spinal cord) Skin Problems Three Legged Spinal Deformity Special Diet Separation Anxiety

Do you understand that we may not know about a behavior or health problem before a dog comes into rescue?  Yes No

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 Friendly Cat Friendly Kid Friendly

Will your current pet(s) accept a new dog?  Yes No Not Sure N/A

If yes, how do you feel they will react?  Favorably Difficult Adjustment Indifferent Don't know

How would you characterize your pet's behavior?  Dominant Submissive Passive Aggressive Passive Aggressive Laid back Polite  Very Sociable Couch Potato Lazy Other

Volunteer and Foster Agreements

Do you understand that Boston Terriers do not tolerate extremes in temperature and are required to be indoor dogs?  Yes No

Do you understand that Boston Terriers are high energy dogs and require a lot of exercise?  Yes No

Do you understand that Boston Terriers can be destructive to toys, furniture, and other things?  Yes No
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?  Yes No

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.  Yes No

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?  Yes No

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?  Yes No

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?  Yes No

Do you agree to have a collar and identification tags on the dog at all times, even if the pet stays indoors?  Yes No

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.  Yes No

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.  Yes No

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.