Foster Application

Applicant's First Name *
Middle Initial *
Applicant's Last Name *
Co-Applicant Name If applicable
Street Address *
City *
State *
Apartment Number (if applicable)
Zip Code *
Phone Number * Please use the following format 248-555-1212
Is this a cell phone Number *
Email Address * Please enter correctly as this is the main way we will contact you
Confirm email
Your Date of Birth * Must by 18 years of age or older
Employment Status *
If you chose "other" above, please explain: *
If you are employed, what is the name of your employer?
Do you own or rent your home? *
Home Owner Information * Please provide name and phone number
Renter Contact Information * Please provide name and phone number
Landlord Information Please provide name and phone number
Does your landlord and lease allow pets? *
Please select your current residence type. *
What is the name of the mobile home park *
If you answered "other" above, please explain here: *
How long have you lived at this address? *
Please provide prior address *
Do you plan to move in the next 6 months? *
Including yourself, how many people live in your household? *
Please list the ages & relationship of those who live in your home. *
Is everyone in your household aware that you are planning to foster? *
Does anyone in your household have allergies to dogs/cats? *
Have you fostered pets before? *
For which organization did you foster? *
What types of animals did you foster and what was your experience? *
Do you currently own other pets? *
If yes, please list their names, breeds, and ages. *
Are any of your pets cats? *
Do your cats spend time outside? *
Are all of your pets spayed/neutered/fixed? *
Why not? *
Are your pets current on their vaccinations? *
If not why? *
Veterinarian's Name * If you have never owned a pet please tell us where you would go.
Veterinarian's Phone Number *
How did you hear about our Foster program? *
What types of pets are you interested in fostering? * Select all that apply
How long can you commit to fostering? * Weeks, months, etc.
How many hours can you devote per day to foster care? *
Will you be able to visit our clinic every 2 weeks for care and paperwork? *
Please provide a description of the planned foster's living space. *
Is there a safe place to keep your foster spearated from your other pets? * When needed or when not at home.
On average, how many hours per day will your foster animal be left alone? *
How will you handle destructive behavior or accidents? *
Are you comfortable administering oral and topical medications? *
How long are you willing to allow for your foster(s) to adjust to your home and schedule? *
Are you willing to meet with potential adopters at our adoption center? *
Under what circumstances would you not be able to complete the foster program and return the animal(s) before an adopter is found? *
What arrangements will you make for the care of your foster in case of an emergency? *
If you answered "other" above, please explain: *
What will you do with the foster when you go on vacation? *
If you answered "other" above, please explain: *
I AM 18 YEARS OF AGE OR OLDER I agree to comply with all local and state laws and ordinances relating to the care of domestic animals and will not engage in any illegal activity with my foster animal. I understand that no foster cat(s) is allowed outside. I understand that the pet I am taking into foster care may not be housebroken and I am willing to train the pet and give it time to adjust to training. I understand that no foster pet(s) is allowed to be left unattended with children. I understand that there are no guarantees of the behavior, health or disposition of my foster. I understand that the pet(s) I am taking into foster care may not be used to living indoors and may scratch or soil my furniture or belongings. If my foster pet(s) is destructive I will confine it to a safe area where it cannot do damage and will work to positively modify its behavior. I will use only positive reinforcement for training and will not use any kind of physical punishment regardless of behavior issues. I understand that CPR may not know the circumstances the pet(s) may have come from and it may take time for the pet(s) to adjust to new situations, people & other animals in my home. I understand that a foster pet(s) cannot be given away to a new home without the adopter coming to CPR to be approved and finalize all adoption paperwork. I understand that a foster pet(s) cannot be adopted until they are spayed/neutered. If I decide that I cannot follow through on my foster care commitment, I will give 48 hours notice. If at any time I feel that my safety or the safety of my family or pets is at risk, I can return my foster pet(s) immediately. RELEASE I/we agree to release, discharge, indemnify and hold Centerville Pet Rescue (CPR), and/or their member/partner organizations harmless from and all damage as a result of and in the providing of any and all services and or products, including but not limited to the adoption of an animal. I recognize that animals at Centerville Pet Rescue (CPR) and/or its member/partner organizations come with the risk of injury or sickness, including personal injury or harm to my family, other individuals and animals. On behalf of myself, my heirs, personal representatives and executors, I hereby release, discharge, indemnify, and hold harmless Centerville Pet Rescue (CPR), its agent, servants, employees, board members, partners, member organizations and sponsors from any and all claims, causes of action or demands, of any nature or cause connected with their services and/or products provided.
Applicant Signature * Sign with touch screen or mouse
Co-Applicant Signature * Sign with touch screen or mouse