This is only an application. A board member will contact you to discuss our program.

Today’s Date: ______________________

Applicant’s Name(s): ___________________________________________________________
Age(s): ___________________

Street Address, City, State, Zip: _____________________________________________________________________________

Home Phone(s): _________________________ Work Phone(s): _________________________

E-mail address: ________________________________________________________________

What kind of pet would you like to foster?

____ Dog: Breed ______________________
I am willing to foster (mark all that apply):
____ pregnant ____ puppy ____ adult ____ senior
____ small ____ midsize ____ large

____ Cat I am willing to foster (mark all that apply):
____ pregnant ____ kitten ____ adult ____senior

Is this your first experience with a pet? ____ yes ____ no

List any pets you have now: ____________________________________________________________________________________________________________________________________________________________

Are all of the pets currently in your household spayed/neutered? ____ yes ____ no

Are all your pets up to date on basic shots and dogs on heartworm preventative? ____ yes ____ no

Who is your current vet and can we contact him/her for a reference? ____ yes ____ no
____________________________________________________________________________________________________________________________________________________________

Do you Rent or Own your home? ____ rent ____ own

If you rent, does your landlord allow pets? ____ yes ____ no
If so, what weight limit? _____________________
Who is your landlord and can he/she be contacted?
____________________________________________________________________________________________________________________________________________________________

How long at your current address: __________________________________________________

How many people are in your household? _____________________

What are their ages? _____________________________________________________________

Does anyone in your household have allergies? ____ yes ____ no

Do all the adults know that you are planning to foster a pet? ____ yes ____ no

Where will the pet be kept during the day? __________________________________________

How long will the pet be left alone? _______________________________________________

Do you have a fenced yard? ____ yes ____ no
If yes, what kind of fence? __________________________

Do you have a swimming pool? ____ yes ____ no

Are you familiar with crate training? ____ yes ____ no

Have you ever housetrained a dog/puppy before? ____ yes ____ no

Can someone visit your home before you foster? ____ yes ____ no

Do you have time and transport to take a pet to the vet? ____ yes ____ no

Do you have time to talk with prospective adopters and do home visits? ____ yes ____ no

Do you think you will be able to give up a pet to a new home after you have fostered it? ____ yes ____ no

Do you realize that sometimes fostering a pet can be a long term commitment? ____ yes ____ no