Susquehanna Service Dogs

Foster Family Application

Before completing this form, please review the following list of responsibilities that Susquehanna Service Dogs expects you to do with your puppy. Early experiences help insure success in later training!

Lots of love and snuggling
Lots of daily exercise – long walks, runs and panting puppies
Diligence with housebreaking
Regular attendance to SSD puppy classes (2-3 times per month)
Special games at least twice a week
Car rides all the time
Walks in populated places
Walks in parks and forests – especially important for young puppies to increase their learning capacity
Go inside to new and interesting places at least once a week
Take the puppy to meetings so it learns to wait quietly
Discourage barking, except during playtime
Absolutely NO feeding from the table – use the dog dish ONLY.
Purchase food. This is the only cost the foster family is responsible for.

To begin the application procedure to volunteer your home to help raise a service dog puppy, please provide the following information.

Application to Provide a Temporary Home for a Puppy Being Raised to Become a Service Dog

* denotes required fields

Contact Information

Name*
Address*
City*
County*
State*
ZIP*
E-mail*
Home Phone*
Work Phone
Comments

Home Information

Is your residence a:*
Single Family Home Apartment Attached Home Trailer
Is your residence in the:*
City Suburbs Rural Area
Do you have a fenced-in area?*
Yes No
If YES, how large (approximate dimensions)?
About how may hours would the dog be left alone on an average day?*
About how many hours would the dog be left alone at any one time?*
Do the other people living with you want the home to be a temporary dog home?*
Yes No
List the Name, Age and Relationship to you of all those living in your home:
Do you have other animals in your home?*
Yes No
If YES, please list the type, sex, whether neutered, and age of each animal:

Availability

Do you have any previous experience with dogs?*
Yes No
If YES, please explain:
Would you be willing and able to attend dog classes?*
Yes No
How long, up to a maximum of 15 months, are you willing to house a dog?*
Would you be willing to house a dog while a trainer or another puppy foster family are on vacation for a few days, or a week or two?*
Yes No
Additional information you would like to provide:

References

Please list at least one person who knows you well, from whom we can obtain a reference.

Name*
Mailing Address
City, State, Zip
Phone*
Relationship to you*
Name*
Mailing Address
City, State, Zip
Phone*
Relationship to you*

THANK YOU for your interest in Susquehanna Service Dogs. When you have completed the entire form, please click on the SUBMIT APPLICATION button below. Your request will be processed as soon as possible. You will be contacted regarding an interview to determine the feasibility of placement of a dog in your home and the availability of a dog for placement.

Contact

Susquehanna Service Dogs: Keystone Children and Family Services; 3700 Vartan Way, Harrisburg PA 17110; Phone: 717-671-7813; E-mail: ssd @ keystonehumanservices.org