AniMeals Foster Application

FOSTER APPLICATION AND AGREEMENT ( Internal Use only )

ApprovedDenied

Date*

Name*

Address*

City*

Zip*

Home Phone Number*

Work Phone Number

Please enter a valid phone number.

Cell Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Occupation

Date of Birth ( Must be over 21 to foster )*

Date

Do you?*

RentOwn

If you rent, what is you Landlords contact Information? Name/Phone Number. If you own, who's name is the property under?*

Do you live in a?*

HouseDuplex/TownhouseApartmentMobile Home

**Cats/Kittens will need to be separate from your own animals and require their own space. What kind of space can you provide?***

Do you currently have any resident pets or fosters?*

YesNo

Please list current pets with their breed, age, sex, and if they are spayed/neutered:*

Who is your current veterinarian?*

Please list a personal reference who live outside your home. Name and phone number required.*

Do you have screens on your windows?*

YesNo

How many adults are in the household?*

Children?*

Ages?*

Have they handled animals before?*

YesNo

Do you, or anyone in your household, have any criminal charges pending or have you ever plead guilty to a crime, including a plea of no contest or deferred prosecution, whether or not an appeal is pending??*

YesNo

If "Yes", please describe the nature of the charges:

What type of transportation do you have?:*

If selected as a foster parent, when would you be able to start?*

Are there certain months of the year you are not available?*

Why do you want to foster?

What kind of animal(s) are you prepared to foster? (Please check all that apply)*

Mother cat with kittens (Can be a 2 month comittment )Litter of orphaned kittens weaned (Over the age of 4 weeks)Bottle Fed Kittens (0-2 weeks of age)Pregnant cats (Can be over a 2 month comittment)Under socialized cats/kittensHospiceCats/Kittens recovering from illness or SurgeryBottle Fed Kittens (2-4 weeks of age)Shelter stressed cats

Can you administer medication to a cat?*

YesNo

If necessary, can you transport a sick or injured foster animal to a vet?*

YesNo

How much time daily do you have for your foster animal(s)*

How many cats can you comfortably foster at one time?*

Have you fostered an animal before?*

YesNo

If yes, for whom?

We require 1 hour of foster orientation would you be able to attend?*

YesNo

WAIVER

As an organization that deals with animals, the AniMeals non-profit does not have a medical or behavioral history of the animals that fosters may come into contact with. A certain amount of risk is always involved, especially with unpredictable animals.

FOSTER AGREEMENT

In consideration of this opportunity to foster with AniMeals, I agree to the following terms and conditions, intending to be legally bound by them:

1. I will abide with the mission, rules, regulations, policies and programs of AniMeals.

2. If I stop being a fosterer, or upon request by AniMeals, I will promptly return all AniMeals supplies, equipment, records and other items in good, clean condition.

3. Considering that fostering positions at AniMeals require dealing with animals, I certify that I am able to perform the essential functions of the position.

4. I assume the risk of being bitten, scratched or injured in connection with my fostering work. AniMeals is not liable to me for any injuries, illness, damages, liabilities, losses, judgments, costs or expenses whatsoever, which I might suffer or sustain in connection with fostering activities, unless they are the result of the gross negligence or intentional misconduct of AniMeals. I will indemnify, defend and hold the AniMeals organization harmless from and against any claims, lawsuits, injuries, damages, losses, costs or expenses whatsoever, sustained by any animal or person in connection with my intentional misconduct or grossly negligent performance of my fostering activities, or my breach of AniMeals rules, regulations, policies and programs.

5. I understand that because I will be in contact with animals, it is important to discuss the tetanus vaccine with my physician. I release AniMeals from all responsibility that may occur because of my not pursuing this matter further and I understand whatever decision I make is at my own risk. I have read, understand and agree to the above tetanus information.

6. I acknowledge and understand that as a fosterer of AniMeals, I am not covered by AniMeal’s workers compensation or any other insurance policy for any damages or injuries I may sustain during fostering activities.

7. If such an incident does occur, I understand that I am to immediately notify an AniMeals employee.

8. I understand that AniMeals may refuse fostering applications or discontinue fostering positions for any reason.

9. I have accurately and truthfully completed this Foster Application and Agreement.

10. I will immediately contact AniMeals if any health issues arise with my foster cats or kittens. If AniMeals is not contacted in an emergency situation I understand I will be denied from foster for AniMeals and will return all cats and their supplies.

11. Any modification to this Agreement must be in writing and signed by both parties. This Agreement is binding upon AniMeals, me and my respective heirs, successors, assigns, executors, and personal representatives.

I have read, understand and agree to the above. I certify that the information provided here is accurate and complete.

Applicants Name*

Date*

Date

Applicants Signature*

Date*

Date

AniMeals Signature

Please verify that you are human*