Foster Questionnaire

Your Contact Information
First Name *
Last Name *
Street Address *
City *
State *
Zip *
County *
Email *
Home Phone
Cell Phone *
Place of Employment *
Work Phone *
We Use a Texting App for Communication/Foster Alerts. Are You Able to Send/Receive Texts? *
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About Your Household
What Type of Housing Do You Have? *	House Apartment Mobile Home Condo Dorm Military

Do You *	Own Rent Live with Parents Other
If You Answered "Other", Please Explain *
If You Rent, Please List Your Landlords Name
Landlord's Phone Number
How Long Have You Lived at This Address? *
If Less Than 6 Months, Please List Your Previous Address
Tell Us About the Human Members of Your Household * We're looking for anyone that lives in on your property. A name, age and their relationship to you is all you need to supply.
Is Everyone in Your Home Agreeable to Fostering (temporarily housing) Cats and/or Dogs for SJRAS? *
How Many Pets Do You Currently Have? *
Pet #1 Please indicate the name, age, breed, sex and fixed or not fixed for pet #1
Pet #2 Please indicate the name, age, breed, sex and fixed or not fixed for pet #2
Pet #3 Please indicate the name, age, breed, sex and fixed or not fixed for pet #3
Pet #4 Please indicate the name, age, breed, sex and fixed or not fixed for pet #4
Pet #5 Please indicate the name, age, breed, sex and fixed or not fixed for pet #5
Addition Pets? List the Same Info as Above for Each. Please indicate the name, age, breed, sex and fixed or not fixed for remaining pets
Your Veterinarian/Vet Office *
Vet Office Phone Number *
Please Describe Any Pets Owned in the Past 5 Years (other than those listed above) * Please list the name, type/breed, age, and where the animal is now or why you no longer have this animal
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Fostering Environment
Do You Have a Fenced In Yard? *
If Yes, How High is the Fence & What Type of Fencing is it? (example: 6ft wooden privacy fence, or 4ft chain-link fence)
How Many Hours Are Spent at Home Each Day (approx.)? *
How Many Hours Can You Dedicate to a Foster Pet Each Day? (on average) *
Please Describe Your Home Atmosphere *	Quiet & Relaxed Moderate Busy & Active
Please Describe Visitors to Your Home (select all that apply) *
Please Choose the Animal Types/Situations that You Would Consider Fostering (select all that apply) *
Please Describe Your Experience with Pets (previous foster experiences, volunteer experiences, jobs, training, certifications, etc) *
You Will Need an Indoor Area to Isolate Any New Foster Pet. Please Describe the Area You Will Use *
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Now The Legal Mumbo Jumbo
Has Anyone in the Household Ever Been Investigated by Any SPCA or Humane Society? *
If Yes, Please Explain
By signing/submitting this form, I certify that I am at least 18 years of age. I also certify that all statements made herein are true. I understand that mamagement has the right to terminate me as a volunteer/foster at any time for any reason at thier discretion. I agree to attend SJRAS's foster orienation and will allow a SJRAS representative to visit my residence for a home visit prior to foster. I understand and agree that any fostered animal will remain the property of SJRAS and I will surrender the animal to SJRAS representatives immeadiately upon request. I also understand that all fosters can only be adopted/transferred through normal SJRAS procedures.
Signature

Center>--------FOR SJRAS USE---------

Interest Session Date
Orientation Date
Orientation By
Signed Waiver

Email Entry Date

Foster Questionnaire

Your Contact Information

About Your Household

Fostering Environment

Now The Legal Mumbo Jumbo