Foster family applications First name* : Last name* : Email* : Phone / Mobile : Your street and number* : Postal code* : City / Town* : Country* : Date of birth* : National number* : Contact person* : Phone / Mobile of contact person : Will you be alone to welcome/work with the future assistance dog? : Yes No If not, who else will be involved?* : Do you have children? : Yes No (how many + ages)? : Are you : Student Employee Self-employed Job seeker Other If you work, what is your work rate (full-time/part-time)? : You live in a : Apartment without garden Apartment with garden House without garden House with garden Do you own a vehicle? : Yes No If not, how do you get around? : Are you willing to collaborate with a trainer from the association once or twice a week for 24 months? : Yes No Are you willing to take your puppy everywhere possible to ensure maximum socialization? : Yes No Do you have other animals at home? : Yes No If yes, which ones? : How did you hear about Os'mose?* : Do you authorize Os'mose to collect your data? : Yes No What are your daily and regular routines? What might your dog be exposed to?* : Privacy policy : Yes, I agree with the privacy policy Fields marked with * are required Send my message
