Pet Fostering Form Tell Us About Yourself First Name* Last Name* Physical Address* Physical Address (con't) City* State* --Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Email address* Primary Phone Number* Example: 555.123.4567 Secondary Phone Number Example: 555.123.4567 What is your age?* Do you own or rent?* Own Rent Live with Parent(s) or Relative(s) Live in Dorm, Military Quarters, etc. Are you prepared to show pet policy?Are you prepared to show pet policy? Yes No Marital Status* Single Married Divorced Widowed Spouse's Name* Is your spouse currently employed?*Is your spouse currently employed? Yes No Spouse's Place of Employment?* Spouse's Job Title* Spouse's Typical Work Days & Hours?* How long has your spouse been employed at his/her current job?* Are you currently employed?*Are you currently employed? Yes No Place of Employment Job Title Work Days & Hours?* How long have you been employed there?* Do you have a completely fenced-in back yard?*Do you have a completely fenced-in back yard? Yes No What type of fence?What type of fence? Privacy Fence Chain Link Fence Other If Other, Explain: Height of Fence? Please check all of the following you have:Please check all of the following that you have Outdoor Dog Pen/Kennel Tie-Out Stake and Lead Doghouse Indoor Crate Doggie Door Please list all other children and adults living in the house with names and ages: How many days per week do you engage in outdoor exercise (i.e., walking, running, biking, etc.) that your new companion would be welcome to tag along for? Does anyone in the household have allergies?*Does anyone in the household have allergies? Yes No What kind of allergies? Does anyone smoke inside the home?*Does anyone smoke inside the home? Yes No Pet Information Do you currently own any pets?*Do you currently own any pets? Yes No Do you currently own any dogs?*Do you currently own any dogs? Yes No Current Dog(s) Name(s), age(s), breed(s), gender(s), spay/neutered What type heartworm prevention do you give them?Are they all on heartworm prevention? None Heartgard Interceptor Revolution Trifexis Other Do you currently own any cats?*Do you currently own any cats? Yes No Current Cat(s) Name(s), age(s), breed(s), gender(s), spayed/neutered? Are any of them de-clawed?Are any of them de-clawed? Yes No Your current pet(s) live (choose one):*Your current pet(s) live (choose one): Indoor Only (Cat Only) Mostly Indoor Outdoor Only Mostly Outdoor Indoor/Outdoor Your new foster pet(s) would live (choose one):*Your new pet(s) would live (choose one): Indoor Only Mostly Indoor Outdoor Only Mostly Outdoor Indoor/Outdoor Where do your current pet(s) stay when you are at work?* Where will your foster pet(s) stay when you are at work?* Where do your current pet(s) stay at night?* Where will your foster pet(s) stay at night? Where do your current pet(s) stay when you are out of town?* Where will your foster pet(s) stay when you are out of town?* Aside from any current pet(s), list all of the pets you have had in the past 5 years and what happened to them: Name, Dog/Cat, Spayed/Neutered, Why have they gone? Current and Previous Veterinarian(s): Name and Phone Number Serious Questions Which pet(s) are you interested in fostering?* If you are intending on fostering more than one pet, please separate their names with commas. Why do you want to foster? Are you prepared to deal with special issues and expenses that a pet can cause? (For example: chewing, scratching, biting, jumping, potty training, flea infestations, bills, etc.)*Are you prepared to deal with special issues and expenses that a pet can cause? (For example: chewing, scratching, biting, jumping, potty training, flea infestations, bills, etc.) Yes No Are you prepared to keep and care for the pet until he/she is adopted?*Are you prepared to keep and care for the pet until he/she is adotped? Yes No To which adoption events can you bring new foster pet?* Saturdays 12-4 Sundays 1-4 Both Sat & Sun Neither Type the characters* This field should be left blank Send Please wait...
