PVCHS Foster Application
Today's Date
*
First Name
*
Last Name
*
Street Address
*
City
*
State
*
IN
IL
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
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 Code
*
What is your home phone number?
What is your work phone number?
What is your cell phone number?
Our fosters will be alerted about available animals via email. What is your email address?
*
How many adults reside in your home? How many children?
What are you interested in fostering?
*
cats
dogs
other
Please select the following types of animals you are interested in fostering:
*
Pregnant/nursing mother with their puppies/kittens
Puppies/ kittens that require bottle feeding
Puppies/ kittens too young for adoption
Animals with medical needs
Hospice animals
Animals with behavior concerns
other
Are you comfortable administering medication?
*
-
Yes, I have administered medication to animals before
Yes, but I will need a demonstration on how to administer the medication
No
Do you have an area separate from your owned pets to prevent injury or the spread of illness?
*
-
Yes
No
N/A
If interested in fostering dogs, do you have a yard?
*
-
Yes
No
I am not interested in fostering dogs.
If you do not have a yard, are you comfortable walking the dog several times daily on leash?
No
Yes
Do you have reliable transportation to bring the animal to the shelter when needed?
*
No
Yes
Have you fostered previously?
*
No
Yes
If you have fostered previously, list the organization(s) you have been involved with.
If you have fostered previously, describe your foster experiences.
What is your valid driver's license number?
*
Have you ever been convicted or investigated for animal cruelty?
*
No
Yes
Please sign your name to finish this application after you verify all above information is correct.
*
Clear