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2. 
4. First Name*
5. Last Name*
7. Address1*
9. Address2
11. City*
12. State*
13. Zip*
15. Email*
16. Phone Number*
20. Do you have experience with medium or large dogs? If so, please describe:*
22. Which of the following behaviors do you feel you can manage confidently/appropriately? Check all that apply. *

    1. Chewing
    2. Destruction
    3. Separation Anxiety
    4. Rude/Mouthy/Jumpy

    1. Reactivity to Strangers
    2. Barrier Frustration/Aggression
    3. On-Leash Reactivity
24. Current Dogs in Home: Age, Sex, and Breed
26. Current Cats in Home: Age and Sex
28. Children in the Home: Ages
32. Some things to consider before fostering:
    • We ask that you do NOT take our foster dogs to a dog park. Compared to a personal pet, we know very little about how our foster dogs might behave in a highly stimulating environment like a dog park.
34. • Please give us as much advance notice as possible if you need to return your foster dog earlier than expected. The shelter is a busy place and we want to ensure we are able to accommodate the return.
36. • Even though the dog is going from a high stress environment (shelter) to a lower stress one (your home), keep in mind this is still a big change for the foster dog. He/she may need extra time to decompress and adjust to the new surroundings. You should be able to provide a quiet place the foster dog can retreat to by themselves if they feel the need (a covered/comfy crate off to the side or in a separate room often does the trick).
40. Terms and Conditions
    1. I agree to provide temporary foster care for the above identified animal(s) for the Norfolk Animal Care Center (NACC) and that my services are strictly voluntary, without pay or compensation of any kind, and without liability of any nature on behalf of NACC.
42. 2. I acknowledge that NACC does not guarantee the temperament, behavior, or health of my foster animal, and I must notify NACC immediately if I believe the temperament, behavior, or health of my foster animal is incompatible with my home environment.
44. 3. I acknowledge that NACC is unable to reimburse personal expenditures for vet care, food, and other items such as toys, leashes, collars, blankets, etc.
46. 4. I acknowledge that if emergency or after-hours veterinary care is needed, NACC authorization is required prior to treatment. I understand that by failing to obtain prior authorization, I may forfeit my right to reimbursement.
48. 5. I agree to abide by all applicable state and local laws pertaining to companion animal care and welfare.
50. 6. I agree to follow any specific care instructions recommended by NACC regarding diet, supplements, and/or medications. I agree to bring my foster animal to NACC for any required vaccinations, deworming, or other prescribed treatments as needed. Absent such instructions, I agree to feed, water, and exercise my foster animal appropriately.
52. 7. I attest that I have never been charged with or convicted of animal cruelty, neglect, or abandonment.
54. By signing below, I agree and attest to the Terms and Conditions outlined above:
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
56. Electronic Signature Agreement*

    1. I agree
57. Electronic Signature*
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59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

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