Foster•Adoption application
Name
*
First Name
Last Name
*
Birthday
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
*
Email
Do you wish to :
*
Please Select
Choose an option
Foster
Adopt
Foster to Adopt
Name of the animal you wish to foster/adopt
*
Please list the people in your household, relationship to you and age
*
Is anyone in your household allergic to pets
*
Please Select
Choose an option
Yes
No
Please list current pets, their sex, age,spayed/neutered , up to date on vaccines
*
Reference: Name•address•phone number
*
Do you live in a
Please Select
Choose an option
House
Condo
Apartment
Military Housing
Other
Do you have your landlords permission to Foster/Adopt including bully breeds
Please Select
Choose an option
Yes
No
N/A
Provide landlords contact information
*
Do you have a yard
Please Select
Choose an option
Yes Open
Yes fully enclosed
No
What type of fencing do you have, and what is the height
Do you have a dog run
Please Select
Choose an option
Yes
No
Do you have an in ground swimming pool
Please Select
Choose an option
Yes
No
How many hours a day are you away from home
Please Select
Choose an option
1-3
4-7
8+
How will your Pawtential K9 animal/s be quarantined away from other pets for 7 days minimum if needed
Where will your Pawtential K9 animal/s be kept day and night
Please state closest Walmart Supercenter to you
*
Veterinary:Name •Address•Phone #
*
How did you hear about us?
*
i confirm i am above 21 years old
*
checked
I accept foster expectations & release of liability
*
Yes
No
N/A
Please attach / upload valid photo identification
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