Feline Foster Survey

Thank you for your interest in our Feline Foster Program! Please remember that the more information you provide, the better. We will use this survey to match foster families with foster cats.

Applicant's First Name *
Applicant's Last Name *
Co-Applicant's First Name
Co-Applicant's Last Name
Primary Phone *
Secondary Phone
Email Address *
Physical Address *
City *
State *
Zip Code
Do you rent or own your residence? *	Rent Own
Landlord's name and phone number If applicable. If you rent your home or land, and you do not provide landlord information, your application will not be considered.
Please describe your household (number of dogs/cats/other pets, children, etc.): *
I am interested in fostering (please select all that apply): *	Bottle babies (0-5 weeks old) Weaned kittens (5-9 weeks old) Nursing mom and babies (varying ages) Pregnant mom Shy cats/kittens Cats/kittens needing medical care Court-Hold Fostering
Are you comfortable giving (if needed):	Oral medication Topical medication Subcutaneous fluids Injections Medicated baths
Please describe where your fosters will be kept: *
Do you have any questions or concerns about fostering? Anything you would like our Cat Program Coordinator to know?
Signature * By signing you are saying that all information provided is true to the best of your ability.	Clear

By signing, I certify that the following information I have given is true. I understand that LCHS reserves the right to deny my application for any reason. I further authorize the investigation of all statements in this application and vertify that I am at least 18 years old. I further understand that submitting this application does not guarantee that I will be become a foster parent for LCHS.