Foster Parent Application

Please provide all requested information, failure to do so will result in a status of an incomplete application

I am over 21 Years old * If you are not 21 or over please do not continue.	NoYes
Personal & Family Information
Name - Last *
Name - First *
Physical & Mailing Address *
City
State
ZIP
Phone *
Email *
Number of people in the home? *
If you have children in the home, how many and ages?
Do you currently have any pets in your household? *	Yes No
If you answered yes, please list all pets in household
Are all pets in household current on vaccines? *	Yes No NA
Are all current pets spayed or neutered? *	Yes No NA
Home Information
Do you rent or own your home? *	Rent Own Gov't Housing
If you rent your home, please provide landlords first name, last name and contact phone number
Please select your current resident type *	House Apartment Condo Townhouse Mobile Home Other
Foster Pet Information
I am interested in fostering a pet *	Long Term Short Term Either
I prefer to foster *	Dogs Cats Rabbits Any
Type of animals willing to foster *	Pregnant and/or nursing kittens abandoned kittens or puppies needing bottle feeding cat/kitten needing medical attention dog/puppy needing medical attention temporary safe house Senior pets Special needs pets
Are you able to administer medications if needed? *	NoYes
Do you have a separate area or room in your home where you can contain and/or confine the foster pet(s), if necessary? *	NoYes
Who will be the main caretaker for the foster pet(s)? *
Where will your foster pet(s) be kept during the day when you are not home? *
Please provide any other comments or info you would like to share with us
Do you agree to direct anyone interested in adopting your foster pet to the Kodiak Animal Shelter? *	NoYes
Personal References
Please provide 2 personal references, please include name, relationship & phone number. *
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations, personal references and veterinarians. I understand that this application does not guarantee fostering approval. *	NoYes

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