Return to Adoptable Dogs

MIDLANDS GOLDEN RESCUE
Foster Home Application Form
As foster parent your task is of the utmost importance. You will be helping a needy Golden Retriever re-adjust and become a secure, healthy dog again. You will be responsible for the day-to-day care and upkeep of the dog. The Rescue will cover any veterinary care as long as it it pre-approved. You must be willing to commit to the dog as long as needed to allow for proper placement in a new home.

Please print out this form and mail it completed to:
Midlands Golden Rescue
Mary Williams (Phone: 803-735-0599)
PO Box 3545
Columbia, SC 29230
Sorry no email.

Name:__________________________________________Home Phone:__________________

Address:_________________________________________Work Phone:_________________

City:_______________________________________________State:_______Zip:___________
Applications without phone numbers will be discarded.

Email Address:_______________________________________________________________

Referred by:_______________________________Veterinarian:_________________________

1. Type of Dwelling:           house           condo           apartment           trailer

2. Do you have fencing (yard, kennel)           yes           no

If yes: Type:                                                        Length:           Width:           Height:

3. Why do you want to foster a Golden Retriever?



Are you willing to commit to the dog until a permanent home is found?




4. Have you ever owned a dog?

5. Do you have other animals? List type, age, sex:



6. Do you have children? List number and ages:




7. Where will dog be during day?                             at night?

8. Are you willing to have a member of the Rescue visit your home prior to placement (by appointment)?

I will be willing to a act as a Foster Home for a rescued Golden Retriever.


SIGNATURE                                                                            DATE:

Revised: 10/00