First Name       Last Name

Address

City     State     Zip

Email Address

Home Phone    Work Phone   Cell Phone 

Do you have children?  Yes   No

Names and ages of children-

Do you have other pets?   Yes  No

How many and what breeds?

Are the spayed/neutered?   Yes   No

Do you own or rent?   Own   Rent   
(If you rent, written approval to house a dog over 80# from your landlord must be submitted)

Choose one:   House DuplexMobile HomeCondoApartmentTown House
Other: 

Do you have a fenced yard?  YesNo   How tall?      

Do you have a swimming pool?  Yes No

How many hours per day will your foster be home alone? 

Where will you keep your foster during the day? 

Where will you keep your foster at night?  

Are you willing to crate and or muzzle your greyhound?  Yes   No

Do you agree to keep a collar and tag on your foster at all times?  Yes  No

Do you agree to contact GPA East Texas immediately if your foster is lost?  Yes  No

Do you have any preferences about your foster greyhound?

Do you agree to administer heartworm preventative when needed? (this will be provided)
Yes  No

Do you have any past experience with greyhounds?  Yes  No

Describe past experience:

I hereby certify that all of the information contained on this form is true and correct.  I agree to keep the foster greyhound, property of GPA/ET, and never use it for racing, hunting or research/experiments.

Name

____________________________________
                                Signature