Name:
Home address:
Home phone:
Cell phone:
Daytime phone:
Best time and place to reach you:
Email address (Please watch your bulk mail folder for email responses from us.):
Type of pet you want to care for:
Dog
Cat
Either
Male
Female
Either
Size of pet best suited to your home and family:
Small
Medium
Large
Any
Does everyone in your household support having senior pets live with you?
Yes
No
N/A
Do any children or grandchildren live in your home or visit regularly?
Yes, Under 8yrs Old
Yes, Over 8yrs Old
No
Are you planning a baby in your future?
Yes
No
Do you or anyone in your home suffer from allergies?
Yes, severe
Yes, mild
Not at all
Who will be the pet’s primary caregiver?
If you move, how will you handle the pets?
Do you own or rent your home?
Own
Rent
What type of home is it?
Single-family residence with yard
Townhome / condo with patio
Apartment – no yard
If you have a yard, is it fenced?
Yes
No
What type of fencing and how high?
If renting, name and address of landlord (verification is required that you are authorized to keep pets in your apartment).
What activity level would your lifestyle provide the pet?
Relaxed, couch potato, walk on the leash every few days.
Daily brisk walks, frisbee / ball-tossing in our back yard.
Sociable – shopping and public events.
Rescued pets typically have suffered varying degrees of neglect and/or abuse and, as a result of such life trauma, may exhibit behavioral issues. Are you prepared for and experienced in dealing with behavioral issues such as chewing, barking, marking, scratching, running away, food aggression, hiding?
Yes
No
What is your general approach to handling behavioral issues? Please also describe what behavioral issues you are willing to work with, and what behavioral issues you refuse to accept in a new pet.
How did you hear about Milagro Senior Pet Refuge Inc?
Have you ever been turned down for volunteering or fostering by any other rescue organization?
Yes (please explain)
No
Have you ever been convicted of a felony?
Yes (please explain)
No
Where will the senior be primarily kept?
Run of the whole house
Garage only
Laundry room
Outside only
Kennel run
Tied outside
Crated inside
How long during the day will the pet be crated or home alone?
8-10 hours
4-8 hours
0-4 hours
Not at all
Most of the seniors that come to Milagro suffer physically, whether through injury, neglect, abuse, or simply age-related infirmities. Acknowledging that there are typically unknown medical issues that come with these seniors, are you still willing to take a 'special needs' senior, to provide the intensive level of care, patience, and attention required to make the remainder of its life comfortable with as much quality as possible, and to remain lovingly devoted to the senior as it reaches its life's end? are you able to also provide financially for this care as needed?
Yes
Maybe
No
Do you have, or have you had in the past 5 years, any other pets?
Yes
No
Please describe (type, age, why you no longer have them):
If you have any questions relative to the application process, or relative to being a Milagro guardian, please list them here.
Please provide names and phone numbers of two character references not related to you.
Please provide name, address, and phone number of your veterinarian.
Security Code
By submitting this application form online, I hereby certify that the information provided herein is true and complete to the best of my knowledge. I understand and acknowledge that I am making application to become a volunteer foster under the auspices of Milagro Senior Pet Refuge, and that the pet for which I am making application will remain under the ownership/license of Milagro during the time that I foster him/her. I also understand and acknowledge that any intentional misrepresentations on my part during this application process likely will prevent approval of my application. Milagro Senior Pet Refuge Inc. is authorized to contact my character references and my veterinarian (and landlord, if applicable) as designated in the answers above.