Adoption/Foster Application Applicant must be at least 21 years old Applicant should live in the Los Angeles Area Applicants other cats/dogs must be neutered Please enable javascript for your browser. Step 01 Did you read the preface to this application which explains our adoption/foster criteria and process? AGAIN, please note - BF rarely places dogs as the only dog in a household where the dog would be left alone for more than 4 hours at a time * Yes, I read the preface No, I did not read the preface If we choose to place a dog with you do you understand/agree to comply with our adoption/foster process? * Yes, I understand and would comply. No, I do not understand/do not agree to comply. Today's Date * Do you wish to foster or adopt? * Adopt Foster What dog do you want to foster or adopt? * You and Your Family First Name * Last Name * Street Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC Zip Code * Do you own or rent? * Own Rent How long have you been at your current residence? * How often have you moved in the past 5 years and reason for the move. * Are you or your civil partner or spouse a citizen of the United States? * Yes No Home Phone * Cell Phone * Email Address * Best way to reach you during the DAY * Cell Phone Home Phone Work Phone Email 1. What is your Occupation ? * 2. What is your age range ? * Under 21 years 21-25 years 26-30 years 31-35 years 36-40 years 41-45 years 46-50 years 51-55 years 56-60 years 61-65 years 66-70 years 71-75 years 76-80 years 81-85 years Over 85 years 3. Name of Spouse/Partner at residence 4. Spouse/Partner Occupation 5. What is your spouse's/partner's age range Under 21 years 21-25 years 26-30 years 31-35 years 36-40 years 41-45 years 46-50 years 51-55 years 56-60 years 61-65 years 66-70 years 71-75 years 76-80 years 81-85 years Over 85 years 6. Other adults (21 or older) at residence. Please list name, age and relationship to you. 7. Name & AGE of children (21 years or younger) at residence. 8. If children live at your home, describe their experience with animals 9. Who is home during the day (you, other family member, housekeeper, etc.) What hours/days? * 10. If the person home during the day is not you, what would their responsibilities be with the dog? * 11. Is anyone at your home allergic to dogs? * Yes, one or more residents are allergic to dogs. No residents are allergic to dogs. I don't know if I/we are allergic to dogs. 12. Will all household members be able to come meet the dog at our adoption fair? * Yes No I/we have already met the dog 13. What is your level of experience with dogs? * Beginner: Have never had a dog. Level 1: Had a dog as a child - never had sole responsibility for care of dog as an adult. Level 2: Currently have first dog since establishing your own household. Level 3: Have always had dogs in your household and consider yourself knowledgeable. Level 4: Have done obedience, agility, guide dog, therapy dog or search and rescue training. Level 5: Have experience rehabilitating difficult dogs: trainer or canine behavioral professional. 14. If Level 4 or 5 please give a brief summary of your experience. Step 02 Your Current Pets 15. What kinds of pets do you have now? * Dog(s) Cat(s) Rabbit(s) Bird(s) Reptile(s) Fish Rodent(s) Do not have any pets 16. Please describe current pets. The more info the better! You MUST include breed, age, gender, weight, length of time in your care. 17. If you've never had a dog or have not had one in your care for more than 5 years why are you interested in becoming a pet guardian now? 18. Are ALL of your current cats/dogs spayed or neutered? * All cats/dogs are neutered. Some pets are neutered None of my pets are neutered Don't have any cats or dogs 19. Have you ever allowed a pet to breed? * Yes, on purpose. Yes, accicentally. No, never allowed a pet to breed. 20. Where do your current pets sleep at night? * Master Bedroom- in dog bed Master Bedroom- on human bed Master Bedroom- in crate Den/ Family room Child's room Laundry room Garage Yard Yard- in dog house Kitchen Don't have any pets Other 21. If Other, please explain 22. Where do your cats spend most of their time? * Indoors only Outdoors only Indoor/Outdoor (both) Do not have any cats 23. Where do your dogs spend most of their time? * Mostly Inside- access to enclosed yard. Inside Only- no yard, taken out for walks. Mostly Outside- allowed in the house sometimes. Outside Only- lives in the yard. Dog door allows inside/outside access 24/7. Only in yard when supervised. Do not have any dogs. Your Previous Pets 24. Please list all PREVIOUSLY OWNED- past pets owned by ALL adult family members in the home. List the pets YOU have owned as well as the pets your spouse/partner/housemates have owned. You MUST include breed, gender, neutered/not neutered, length of time owned and you MUST include what happened to them; how they died, put to sleep, given away, given to shelter, lost, stolen, etc. and the circumstances for each situation. If you do not currently have a dog please let us know how long it has been since your last dog. Please also distinguish between pets you have owned/been solely responsible for as an adult and pets that were part of your family growing up/family dogs. The more info the better! * 25. Have you ever given a pet away? * Yes No 26. If yes, please describe Step 03 Your New Pet 27. What are your reasons for adopting/fostering a dog? * Companion for Yourself Companion for your Children Companion for your current Pet Companion for whole family Watchdog Gift Other 28. If Other, please explain 29. How would you train/discipline your dog? * Obedience class Hit with Newspaper Firm verbal commands Clicker/hand signals Other 30. If Other, please explain 31. Who will groom/bathe your dog? * Groomer Vet Myself Other 32. What level of exercise would you like with your dog? * Very active- long brisk walks, hiking, jogging, etc. Moderately active- normal paced, normal length walks around the neighborhood. Low level activity- couch potato! Not sure 33. How would you walk your dog? * Off leash always On leash always Sometimes on, sometimes off leash On leash on street, off leash hiking Other 34. What kind of walking device will you use? * Leash hooked to regular collar Leash hooked to harness Leash hooked to soft choke/slip collar Leash hooked to choke chain Leash hooked to haltee or gentle leader None- walk off leash Other 35. What kind of leash will you use? * Retractable leash Regular nylon or leather leash Will not walk dog on leash Other 36. If you answered "Other" to question 33, 34 and/or 35, please explain 37. Would you allow your dog to wear a permanent Bill Foundation ID tag? * Yes No 38. When would your dog wear an ID tag? * Always 24/7 Only on walks Only daytime Only nightime Never 39. What would your dogs ID tag include? * Name Address Home phone Cell phone Microchip number Will not have ID tag 40. Do you have a veterinarian? * Yes No Yes, but I would like to find a new one. 41. If you have a vet please provide the name of the practice, the name of the vet you prefer to use in that practice, address, and phone number, and/or email. Vet First Name Vet Last Name Vet Street Address Vet Address Line 2 Vet City Vet State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC Vet Zip Vet Phone Vet Email 42. What brand of food will you use/do you use for current pets? * 43. What type of food? * Dry kibble only Canned/wet food only Combination of Dry & Canned Home cooked/ raw diet 44. How would you feed? * One scheduled meal a day Two scheduled meals a day Free feed (leave food out) 45. Who will take care of your dog when you go away? * Dog will stay at a Kennel Dog will stay at a Cage-free Daycare Hired pet-sitter will stay at my house (leave food out) Friend will stay at my house Relative will stay at my house Dog will stay at friends house Dog will stay at a relatives house Someone will stop in to feed/walk the dog Other 46.If Other, please explain 47. Where will your dog sleep at night? * Master Bedroom- in dog bed Master Bedroom- on human bed Master Bedroom- in crate Child's room Laundry room Den/family room Garage Yard Yard- in dog house Other 48. If Other, please explain 49. How many total hours per day would the dog at home without a human present? Please consider and include commute time, work hours and after work activities. How many days a week will the dog be home alone for these hours? Please provide as much detail about your schedule as possible. * 50. Where would the dog be when left alone? * Inside only - run of the house Inside only- confined area Inside only- in crate Outside only- run of yard Inside and Outside access (dog door) Confined to garage Other 51. If you will be gone for more than 5 hours what would you provide? * Bring to dog daycare Walk before & after Dog door to yard Come home at lunch Hire dog walker Wee-Wee pads None of the above 52. Please describe, in detail, the area where the dog would be left alone? * Step 04 Your Home & Yard 53. What type of home do you live in? * House Apartment Condo Townhouse Duplex Mobile Home Guest house Other 54. Would your dog be allowed to sit/sleep on your couch(s)? * Yes No 55. Would your dog be allowed to sit/sleep on the bed? * Yes No 56. Are any rooms off limits to the dog when you ARE home? (please be specific) * 57. Are any rooms off limits to the dog when you are NOT home? (please be specific) * 58. Do you have a dog door? * Yes No 59. When will dog door be accessible? * Always- 24/7 Only when someone is home Only when someone is not home Day only Night only Do not have dog door 60. When outside, what shelter would be available to the dog? * Dog house Covered patio/balcony Garage Don't have outdoor area No shelter Trees only Dog door allows dog to come inside 61. If Other, please explain 62. What kind of outdoor areas do you have? * Private yard Shared yard Private patio balcony Do not have outdoor area Other 63. Is your back yard enclosed? * Completely enclosed Partially enclosed Not enclosed Do not have a back yard 64. Is your front yard enclosed? * Completely enclosed Partially enclosed Not enclosed Do not have a back yard 65. What kind of enclosure(s) does your yard/patio have? * Wood fence Chain link fence Iron fence Block wall Don't have yard or patio 66. If Other, please explain 67. What is the height of your fence/wall at the tallest point? * 68. What is the height of your fence/wall at the shortest point? * 69. How many gates do you have on your property and what is their height? * 70. What kind of latch/lock do you have on your gates? * Latch only Latch & padlock Installed key lock Do not have gates 71. If your gates do not have locks would you agree to install gate locks? * Yes No Already have locks Do not have any gates 72. Please inspect your fence; what is the current condition? * The fence is secure The fence is not secure; I need to make repairs The fence is not secure; I am not willing to make repairs Don't have fence/yard 73. Other than household members, who has access to the enclosed part of yard? * Gardener Poolman Utility UPS, mailman FedEx, etc Housekeeper Nanny Workmen Family (non residents) Neighbor/friends Water bottle delivery person Tenant Other 74. Would your dog be allowed in the yard when workmen, gardeners, poolmen, etc. are present? * Yes, my dog would have OFF LEASH access to the yard when workers are expected No, my dog would be kept inside if workers are expected The fence is not secure; I am not willing to make repairs I do not have a yard 75. Do you have a pool? are present? * Yes, pool is enclosed No, Yes, pool is not enclosed I do not have a pool 76. Do you have an electric driveway gate? are present? * Yes, dog WOULD have access to driveway No, Yes, dog would NOT have access to driveway No driveway gate Step 05 Your Commitment 77. Pets are an investment; if you are adopting, can you afford to provide medical care, grooming, proper diet and shelter for a pet for the rest of its life? * Yes No I'm not sure 78. A dog can live to be 20 years old; if you are adopting, are you able to make this long-term commitment? * I'm not able to make that commitment I am able to make that commitment I'm not sure if I can make that commitment 79. In the unlikely event your living circumstances change in such a way that you are no longer able to keep your dog, are you able to make arrangements with a relative or close friend to take over care? If so, please describe who would care for your dog, along with details about their relationship to you, location and home environment. * 80. If these resources (family or close friend who would agree to be designated care-taker) are not available to you, would you able to make a financial provision for your dog should the dog need to be returned to BF for re-homing? Please explain. * 81. If you are adopting, should your pet became ill, gets injured, needs surgery, needs ongoing medical care, etc. what amount are you willing to spend on veterinary/medical care? If you'd like to make additional comments please use the space below. If you have trouble understanding this question please click on the question mark button for assistance.? * $500 $1,000 $2,500 $5,000 $10,000 no limit, whatever is necessary 82. We recognize that the previous question (regarding veterinary care/expenses) is a tough question to answer hypothetically. We invite and encourage you explain your answer and to share your thoughts 83. If you are adopting and the dog you adopt becomes ill (whether it is 6 months or 6 years after you adopt the dog) would you want to return him/her to Bill Foundation? * Yes, I would want to return a sick dog No, I would take responsibility for the sick dog 84. If you are adopting, what will happen to your dog if you move locally? * 85. If you are adopting, what will happen to your dog if you move out of state?* 86. If you are adopting, what will happen to your dog if you move out of the country?* 87. If you are a renter and planning to adopt, should you encounter difficulties with your landlord or have to leave your current rental for any other reason what will you do? If you have trouble finding a pet friendly rental what will you do? 88. If you are planning to adopt, what might prompt you to return your dog to Bill Foundation? (check all that apply) * New spouse/partner doesn't like dog New pet and resident pet don't get along Financial problems Not housetrained Poor watchdog Growling at guests Dog becomes ill You become ill Destructive chewing Excessive vet bills Agressive on leash Excessive barking Marking in house Dog gets old Shedding Allergies Moving Biting Digging Divorce None of the above 89. If you are adopting and the dog you adopt becomes ill (whether it is 6 months or 6 years after you adopt the dog) would you want to return him/her to Bill Foundation? * Yes No I don't know 90. Why are you interested in adopting/fostering from a rescue?* 91. How did you hear about Bill Foundation? * 92. Which Bill Foundation dog are you interested in and why you are interested in this particular dog or type of dog? If you don't know which dog or type of dog you want, please describe as best you can what appeals to you and your family: age, size, gender, breed, shedding or allergy issues, personality, etc.* 93. ADDITIONAL INFORMATION: Please use this space to provide other pertinent information about your self, your home, etc. Anything you would like to share with us!etc. Step 06 Statement Of Understanding Please read the following statements and choose the appropriate answer below 94. If I adopt a Bill Foundation dog I am able to make a suggested minimum tax deductible donation of at least $350 for EACH* dog adopted. I understand that my donation is a contribution freely given, not a purchase price, and that no goods or services have been or will be provided in exchange for my tax deductible donation. I understand that tax deductible donations are NOT refundable. * If two dogs are adopted together, the MINIMUM recommended tax deductible donation would be $700. Please note, Bill Foundation does not have an endowment, nor do we receive any funding from any city, county, state or federal sources. We are completely dependent on our own efforts to raise funds to continue to rescue, rehabilitate, and place wonderful dogs like the one (or two) that you would like to adopt. Because we regularly rescue dogs at high risk of euthanasia due to serious medical issues such as broken bones or illness, and because we are committed to the well being of our dogs and continue to pay for their care no matter how long it takes for them to be adopted, our average cost per dog from rescue to placement is well over $2500. If you can afford to give more than the recommended minimum donation, please know that every tax deductible penny goes directly toward caring for and placing our dogs and makes possible the continuing cycle of life saving rescue, rehabilitation and placement.: I CAN make a minimum suggested tax deductible donation of $350 or more. * I CAN make a contribution of at least $350 I CAN NOT make a contribution of at least $350 Application to Foster N/A 95. I understand that a home visit is required and that a home visit does not guarantee placement. * I understand and agree to a home check I do not understand or agree to a home check 96. I understand that submitting an application does not mean I am approved to adopt or foster a dog from Bill Foundation. Bill Foundation has the right to refuse adoption/foster to any applicant for any reason. Bill Foundation is not obligated to provide a reason or explanation for refusing adoption/foster to applicant. * I understand and agree I do notunderstand and not agree 97. Please add me to the Bill Foundation mailing list. (we keep your information private; we do not sell or exchange mailing lists with anyone.) * Yes, put me on the mailing list! A copy of this application will be sent to your email. Please provide your email address * We receive many applications, emails and phone calls. We will review your application and, if we think that you might be an appropriate home for one of our dogs, we will be in touch with you. Should you want to follow up on the status of your application we can be contacted at: billfoundation@billfoundation.org. Thank you! BE SURE TO PRESS SUBMIT ONLY ONCE!
