|
|
2/6/2012 |
| First Name |
|
| Last Name |
|
| Street |
|
| City |
|
| Email |
|
| State |
|
| Do you have
pets |
|
| Vet's
Name |
|
| Vet's phone
number |
|
| list your pets
(name, breed, age, sex) |
|
| phone home |
|
| phone cell |
|
| How did you
hear about us? |
|
| Are all your
dogs spayed? |
|
| If no; why
not? |
|
| Are you able to
foster? |
|
| Are you able tp
transport |
|
| Will you do a
home visit |
|
| Are you able to
work on admin projects |
|
| other things
you want to do? |
|
| Have you ever
fostered a dog? |
|
| IS there a time
limit on fostering explain please |
|
| will you pay
for the food for the dog |
|
| Will you take
the foster dog to the vet (at the rescue cost) |
|
| Will you do
home checks |
|
| How many hrs
will the dog be alone durring the day? |
|
| Did you have
past pets |
|
| Do you have a
past vet |
|
| Do you live in
a house, apt etc..? |
|
| rent or own |
 |
| Lanlord name |
PH: |
| Do you have a
fence? |
|
| kind of
fence |
|
| fence_height |
|
| Number of men
live in the home |
|
| Number of women
live in the home |
|
| kids in the
home |
|
| kids_Ages |
|
| A friend of
yours (name & phone) |
|
|
It is understood and agreed to that the below discloser of
any Friends of Penny Min Pin Rescue private group information may provide
certain information that is and must be kept confidential. To ensure
the protection of such information, and to preserve any confidentiality
necessary, it is agreed that:
1. The Confidential Information to be
disclosed can be described as and includes:
Group members emails,
inside rescue information relating to proprietary ideas vetting costs,
profit and margin information, finances and financial projections,
members, directors, owners, customers, clients, marketing, and current or
future business plans and models, regardless of whether such information
is designated as "Confidential Information" at the time of its
disclosure.
2. The Recipient shall limit disclosure of Confidential
Information within its own organization. The Recipient and
affiliates will not disclose the confidential information obtained from
the discloser unless required to do so by law.
3. Although this
Agreement may be signed by the Recipient prior to signature by Discloser,
the obligations herein will become effective only upon the Recipient
receiving a clicking the form button "I agree" on the Friends of Penny Min
Pin Rescue Group copy of the Agreement.
WHEREFORE, the parties
acknowledge that they have read and understand this Agreement and
voluntarily accept the duties and obligations set forth
herein |
|
|
| - Required field |
|
|