Foster Care Application Step 1 of 3 - Personal Information 0% * = required fieldsApplicant Name* First Last Address* Street Address City Choose OneAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone:*Cell:Work:Email:* You live in: House Apartment Duplex Household is: Quiet Active Does your home have a yard? Yes No Is the yard fenced: Yes, it is fenced No, it is not fenced Do you: Own Rent Live w/Parents Live w/Roommates Landlord's Name First Last Landlord's Phone NumberParent 1 Name: First Last Phone Number:Parent 2 Name: First Last Phone Number:Are you allowed to have pets? Yes No Do all adult members of your household want to and/or agree to the foster? Yes No If not, explain: How many people live in your home?List all people who live in your home (excluding yourself)NameRelationshipAge NameRelationshipAge NameRelationshipAge Click the + icon to the right of the "age" field to add a new row.NameRelationshipAge Click the + icon to the right of the "age" field to add a new row.Personal Pet ProfilePlease provide details of all pets currently a part of your household.Pet's NameType/BreedAgeGenderCurrent on Vaccinations?Spayed/Neutered? Pet's NameType/BreedAgeGenderCurrent on Vaccinations?Spayed/Neutered? Pet's NameType/BreedAgeGenderCurrent on Vaccinations?Spayed/Neutered? Pet's NameType/BreedAgeGenderCurrent on Vaccinations?Spayed/Neutered? Pet's NameType/BreedAgeGenderCurrent on Vaccinations?Spayed/Neutered? Pet's NameType/BreedAgeGenderCurrent on Vaccinations?Spayed/Neutered? Would you be willing to care for a foster pet that is ill, needs medication or is disabled in some way? Yes No Do you think your pet(s) will get along with a foster pet? Yes No Why or why not? Please list any requirements you have for a foster pet (i.e. size, temperament, gender, etc.)If yes, please explain: Do you feel you could foster more than one pet at a time? Yes No If yes, how many at one time:What kind of pets are you interested in fostering? Puppies (under 6mos) Dogs (6+mos) Mother Dog w/Newborn Puppies Orphaned Newborn Puppies Kittens (under 6mos) Cats (6+mos) Mother Cat w/Newborn Kittens Orphaned Newborn Kittens How long would you be able to foster a pet? 1-3 days only Up to 1 week 1-2 weeks 3-4 weeks As long as needed How many hours in a day will your foster pet(s) be home alone?Check all that apply Someone is usually always home 1-4 hours alone 8-12 hours alone I have a doggie door I come home on lunch break I bring my pet to work with me Other If other, please explain: Where will you keep your foster pet during the day while gone? Inside Outside Please explain: Where will you keep your foster pet during the day while home? Inside Outside Please Explain: Where will you keep your foster pet at night? Inside Outside Please explain: Do you have all of the supplies necessary to care for a foster pet? Yes No If not, what kinds of supplies will you need the rescue organization to provide? Is this your first experience with a dog, a cat, or with fostering? Yes No Please explain: What training methods are you familiar with, if any? Would you be willing to transport a foster pet to vet appointments and adoption events? Yes No If not, please explain: Do you have a cat and/or dog crates to use for transports? Yes No Please tell us anything else about yourself or your family that you feel this organization would need or want to know (i.e. previous experiences, why you want to foster, other groups you have worked with, special skills, personal contacts, etc.): Δ
Hearts 4 Paws Mailing Address
