Name:  Website (if applicable):

Address:

City: State: Choose AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY  Zip:

Home Phone: Work Phone: E-Mail:

Cell Phone: Fax:

To insure that this Foster Home Placement is in the best interest to both you and the Animal, we ask that you answer the following questions:

Are you willing to spend the time and share the space to properly care for this animal during its foster care? Yes No

Shelter animals have sometimes been in neglectful and/or abusive situations and; therefore, may experience difficulty making the transition to a new foster home. Are you willing to be patient while the animal adjusts to the new foster home?
Yes No

What is your current living arrangement? House Apartment Duplex Mobile Home Condo

How long have you lived at the above address? Yrs Mos

Do you rent or own? Rent Own

If you rent, does your lease allow pets? Yes No

If applicable, please provide:

Landlord Name:
Phone Number:

Please list the following information for all persons living in your household (including self):

Will the animal be kept: Inside Outside
Where will the animal be kept during the day? (be specific)
Where will the animal be kept during the night? (be specific)
Where will the animal be kept when you are at home? (be specific)
What will you do with the animal when you go on vacation? (be specific)
Do you have a fenced in yard? Yes No
Fence Type Height

Is this your first experience fostering an animal? Yes No

Do you own any pets at the present time? Yes No

If yes, please provide the following information:

Name	Type of Pet	Breed	Age	Sex	Spayed	Neutered	Unaltered	Notes
	dog cat guinea pig hamster rabbit snake iguana bird mouse horse pig other Choose			M F
	dog cat guinea pig hamster rabbit snake iguana bird mouse horse pig other Choose			M F
	dog cat guinea pig hamster rabbit snake iguana bird mouse horse pig other Choose			M F

Please list any additional pets or information below:

How will you ensure the safety of the newly fostered animal as well as your existing pet(s) in regard to the initial stages and introduction of animals to one another? (even the most calm and predictable pet may act out-of-character to a new animal)

How many dogs or cats have you owned in the past 6 years that you no longer own? Dogs Cats
Please explain why these animals are no longer in your care (be specific):

Who is your veterinarian? Phone:

Please list the names and phone numbers of three references (of those, please list at least two non-family references) with which we could discuss your fostering a shelter animal:

Why do you think you would be a good foster home for one of the shelter animals?

NOTE: You will be required to sign a printed application if you are approved.

Please review your information, and then click here to . You will be able to preview your information before you submit it.