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Westie
Rescue of Northern California
A Service of the Application to Provide Foster Care |
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Westie
Rescue of Northern California
A Service of the Application to Provide Foster Care |
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| Part I - Personal Information
Name: ______________________________________________________________________________ Address: ____________________________________________________________________________ City: ____________________________________________State: ___________Zip: _______________ Telephone (Day): ______________________________ (Evening): _____________________________ E-mail address:_______________________________________________________________________ Number of adults in household: _____________________ # Men ____________ # Women __________ Your employer's name: ________________________________________________________________ Employer's address: ___________________________________________________________________ ____________________________________________________________________________________ Days and hours you work outside the home: _______________________________________________ ____________________________________________________________________________________ Children ______________________ Boys (ages) ________________ Girls (ages)__________________ Do you own or rent your dwelling? ________________________________________________________ What type of dwelling: (Please check/circle appropriate)
If other (please specify): ____________________________________________________________________________________ If you rent, do you have the landlord's permission to keep a dog?_______________________________ Landlord’s name: _____________________________________________________________________ Landlord's address: ___________________________________________________________________ Landlord's phone number: ______________________________________________________________ Would you be willing to allow us to visit your home? _________________________________________ In which areas of rescue are you interested? (Please check/circle all that apply)
If other, please specify: ________________________________________________________________ What type of vehicle do your drive?_______________________________________________________ What areas are you willing to cover with regard to transporting a rescue? (Please check/circle appropriate)
* San Francisco, Alameda, San Mateo, Marin, Contra Costa, Santa Clara & Sonoma Counties. List additional dog equipment you have (crates, leashes, collars, food bowls, etc.) ____________________________________________________________________________________ ____________________________________________________________________________________ Part II - Environmental Information How large is your yard? ________________________________________________________________ Is it securely fenced? (If "yes" what kind and how tall?) ______________________________________ ____________________________________________________________________________________ What type of gates? ___________________________________________________________________ Can children open the gates? ___________________________________________________________ If you have a pool, is it fenced separately? (If "yes" what kind and how tall?) ____________________________________________________________________________________ Are you aware of any dangers that could harm the dog inside the yard? ____________________________________________________________________________________ If your yard is not fenced, how do you plan to ensure that the dog receives safe and adequate exercise? ____________________________________________________________________________________ ____________________________________________________________________________________ Where will the dogs sleep?______________________________________________________________ Do you plan to use a crate? Why or why not?_______________________________________________ ____________________________________________________________________________________ How many hours a day will the rescue be alone? ____________________________________________ Where will the rescue stay when alone? ___________________________________________________ If needed, can you isolate a rescue? (If "yes", where will isolate the rescue) ____________________________________________________________________________________ Part III - Your Pets Have you ever owned a Westie before? (If "yes", how many and how long?) ____________________________________________________________________________________ Where did you get your Westie(s)? ____________________________________________________________________________________ What happened to your Westie(s)? ____________________________________________________________________________________ If you have never owned a Westie, please describe the Westie personality and temperament: ____________________________________________________________________________________ ____________________________________________________________________________________ Do you have any other pets at this time? What kind, sex and age? ____________________________________________________________________________________ If you have other pets, are their vaccinations current? ____________________________________________________________________________________ If you don't have a pet now, have you owned one before? ____________________________________________________________________________________ If you have other animals what has been your main health and/or behavior problem(s) with them? ____________________________________________________________________________________ ____________________________________________________________________________________ If you have other dogs, would you consider them aggressive or submissive to other animals? (If "yes", please explain) ____________________________________________________________________________________ ____________________________________________________________________________________ How do you think your other pets would react to a rescue dog? ____________________________________________________________________________________ Are you prepared to deal with negative reactions on the part of your pets? ____________________________________________________________________________________ Part IV - Foster Preferences Are you willing to foster a Westie for a short period of time? ___________________________________ Are you willing to foster until the Westie is placed? __________________________________________ Why do you want to foster a Westie? _____________________________________________________ ____________________________________________________________________________________ What type of Westies will you take? (only males, only females, only older dogs) ____________________________________________________________________________________ Would you be willing to take a dog that did not fit this criteria in an emergency? ____________________________________________________________________________________ Are you prepared to provide the extensive socialization that is needed to ensure that you have a well-rounded Westie for placement? ____________________________________________________________________________________ Are there any situations to which you WILL NOT be able to expose a foster dog? (Please check/circle all that apply)
What medical considerations will you make in taking a rescue dog? (e.g. won't take a dog diagnosed with heartworms) ____________________________________________________________________________________ ____________________________________________________________________________________ Are you agreeable to spaying/neutering EVERY dog that you foster? (Please state your reason) ____________________________________________________________________________________ ____________________________________________________________________________________ How many dogs are you willing to foster at once? (Circle) 1 2 3 4+ Are you likely to do any training with the foster dog while in rescue? ____________________________ What type of training and how much? ____________________________________________________________________________________ What is your definition of disciplining a dog? ____________________________________________________________________________________ ____________________________________________________________________________________ How will you deal with behavior problems in a rescue? (e.g. aggression, urination) ____________________________________________________________________________________ ____________________________________________________________________________________ Part V -Tough Decisions Would you be able to handle a dog that after it has been rescued is diagnosed with an illness and has to be euthanized? ____________________________________________________________________________________ Are you agreeable to having dogs euthanized because of temperament problems? (Please explain why or why not) ____________________________________________________________________________________ ____________________________________________________________________________________ If "NO" what would be your alternative solution? ____________________________________________________________________________________ Are you willing to take Westie mixes? ____________________________________________________ How would you handle a situation in which a rescue dog bit you? ____________________________________________________________________________________ ____________________________________________________________________________________ Or bit someone else? ____________________________________________________________________________________ Would you be willing to deny an adoptive family a particular dog because the placement didn't "feel" right? ____________________________________________________________________________________ Does your family support your desire to aid Westies in rescue? ____________________________________________________________________________________ Are you willing to work closely with the SFBWHWTC Rescue Committee in making a placement for the rescue dogs? ____________________________________________________________________________________ Have you emotionally prepared yourself for the sadness that comes when you finally make a placement? ____________________________________________________________________________________ Are you willing to stay in contact with the adoptive home to ensure the placement was a success, including follow up visits and/or phone calls? ____________________________________________________________________________________ Are you willing to provide counseling/resources to the adoptive family should problems arise later on in the placement? ____________________________________________________________________________________ Please describe your experiences with obedience classes. ____________________________________________________________________________________ ____________________________________________________________________________________ Please describe your competition experiences with dogs, if any. ____________________________________________________________________________________ ____________________________________________________________________________________ Please describe other volunteer experiences you have had. ____________________________________________________________________________________ ____________________________________________________________________________________ Please list memberships in dog and other animal related organizations: ____________________________________________________________________________________ Is there anything else that you want to tell us about your family and its suitability to foster a rescue Westie? ____________________________________________________________________________________ ____________________________________________________________________________________ How did you find out about us? ____________________________________________________________________________________ Your comments or suggestions: ____________________________________________________________________________________ ____________________________________________________________________________________ Part VI - References Please list three (3) references that can attest to your suitability as a pet owner, and more specifically, a foster parent in Westie rescue. If you own any pets now, include your Veterinarian and at least one neighbor as references. Reference #1: ________________________________________________________________________ Address:____________________________________________________________________________ City, State, Zip: ______________________________________________________________________ Phone: (day and evening) ______________________________________________________________
Reference #2: _______________________________________________________________________ Address: ___________________________________________________________________________ City, State, Zip: ______________________________________________________________________ Phone: (day and evening) ______________________________________________________________
Reference #3: _______________________________________________________________________ Address: ___________________________________________________________________________ City, State, Zip: ______________________________________________________________________ Phone: (day and evening) ______________________________________________________________
I, the undersigned, attest, to the best of my knowledge, the above information is accurate and complete at the time of signing, and I understand that falsely provided information can mean that my application will be terminated. Signature__________________________________________ Date_____________________________
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Thank you for completing this questionnaire. This will greatly aid us in knowing what your limitations are and in what capacity that you will best be suited in rescue. Please be aware that foster help doesn't just end with the placement, nor does keeping the dog in your home constitute all of the needs of rescue. Every individual is suited to a different aspect of rescue. We will work with you to assign you in a capacity where you are comfortable and can make a difference. Though sometimes it is hard to let go of a rescue dog, we all know that there is another one that could be just as needy, if not more, just around the corner. When you are able to make a successful placement, the pain is all worth it. Thank you for your cooperation. Please return this form at your earliest convenience to:
If you have any questions about this form, please contact one of the SFBWHWTC Rescue Committee members below:
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