Adoption/Foster Reference Questionnaire
Adopter/Foster Applicant's Name
*
First Name
Last Name
Your Name
*
First Name
Last Name
Your phone number or email address
*
Please rate the applicant based on Your overall approval of their lifestyle, home, household and ability to provide stability for a pet
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1
2
3
4
5
Pertaining to the care of a dog/pet; To the best of your knowledge, is the applicant?:
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Financially Secure
Physically able to care for a pet
Able to provide a safe home
Emotionally/Mentally Sound
How long have you been acquainted with the applicant?
*
Have you visited the applicant's home?
*
If there are other members in the applicant's household (roommates, children or otherwise), do you feel a dog/pet would be safe in their care? (Please feel free to elaborate)
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If there are other pets in the applicant's household, do they appear to be well cared for? Also, are there any concerns that the pets don't like other pets/dogs? (Please feel free to elaborate)
*
Please provide any additional information for consideration below:
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Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: