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2. All fields marked with an asterisk (*) are required.
4. First Name*
5. Last Name*
7. Address1*
9. Address2
11. City*
12. State*
13. Zip*
15. Phone Number*
16. Email Address
18. The following criteria are required for all dog foster volunteers. Please check each correct response.*

    1. I certify that I am 18yrs of age or older
    2. I am a Contra Costa County resident
    3. I have immediate and reliable transportation to transport a foster dog to and from the shelter and/or an emergency clinic if needed
    4. Foster dogs and resident animals need to be kept separated, at least for an initial decompression period. I understand that if an introduction is attempted it is done so at my own risk
20. Type your name as a signature verifying you meet all the above requirements*
22. Which foster options are you interested in? Check all that apply.

    1. Short term foster (3-5 nights)
    2. Long term foster (5+ nights or until they are adopted)
24. Is there a specific size of dog that you are comfortable working with or capable of taking home (Check all that apply)*

    1. Small
    2. Medium
    3. Large
    4. Extra Large
26. Do you have personal dog experience? While experience is not required, are there any behavior challenges that you feel comfortable managing and training (i.e. jumping, pulling on leash, dog reactivity)?*

    
    

28. Are there any breeds of dogs you are NOT comfortable working with? If so, what breeds? *
30. Please list the age of all members residing in the home, including any/all children. If you plan on having children or other visitors while housing a shelter dog, please list that below.*
32. Are there other animals in your home? If so, please list their species and age.*
34. Do you currently rent? If so, is it an apartment or house? Are there any size or breed restrictions? *
36. Is there any additional information that you would like to give us about your household that might help us choose the right option for you?
38. Did you have a specific dog in mind? Please include Name and Animal ID#
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40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

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