Foster Application Form

Are you interested in fostering dogs, cats, or both?

Full Name

First NameLast Name

Age

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Primary Phone Number

Area CodePhone Number

Secondary Phone Number

Area CodePhone Number

Spouse or Emergency Contact's Name

Spouse or Emergency Contact's Phone Number

Area CodePhone Number

Do you live in a:

Do you:

If Renting: Please indicate landlord contact information

Household Setting

Describe your Homes Activity Level

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)

Does Anyone in your Household have Allergies to Animals?

Are all members of your family agreeable to fostering an animal?

Please List any Pets you have (Please include Name, Breed, Age, Altered, Gender, Current on Vaccines)

If necessary, how will you keep the PBAA animal isolated from other animals in the home?

Do you have a preference in sex of foster?

Are you willing to foster an animal of any age?

If not, what age would you consider?

What size dog are you willing to foster? (Check all that apply)

Please describe the type of animal you are willing to foster (Please include breed, coat length, personality traits, energy level, house/litterbox trained, good with kids, etc.) We always want to make sure we have the best fit for our foster homes.

Are you willing to take your foster animal to vet appointments at a convenient time for you?

Do you drive or have access to a vehicle to bring your foster to events and appointments

If No please explain

Are you willing and able to medicate your foster, even if it just a monthly heartworm preventative?

We cannot guarantee a dog to be housebroken/cat to be litterbox trained, are you equipped to train with love and patience?

Are you willing to use a crate for a dog if recommended?

Do you have a fenced yard?

If fenced, please give details on height, material, # of gates, are gates locked or lockable? If not fenced, how do you plan to let your foster outside?

Do you have a dog door?

Do you have a pool?

How many hours in a day would the foster be left alone?

Where will the PBAA animal be kept during the day? At Night? (PBAA STRICTLY FORBIDS FOSTER CATS FROM GOING OUTDOORS)

Please list 2 personal references with names, addresses, phone numbers and how related. We prefer it not to be all relatives. Are you ok with this?

Vet Reference: Full Name

Business NameVet's Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number:

Personal Reference #1: Full Name

First NameLast Name

Phone Number

Area CodePhone Number

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Reference #2: Full Name

First NameLast Name

Phone Number

Area CodePhone Number

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully. I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Permian Basin Animal Advocate animal fostered by me. I certify that the above information is correct, and I understand that the information will be verified. I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Permian Basin Animal Advocates and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster animal. I accept full responsibility for the animal(s) actions at all times, and release Permian Basin Animal Advocates from any liabilities or damages that may be incurred because of fostering such animal(s). If applicable, I agree to have Permian Basin Animal Advocates complete reference call checks and conduct a home visit inspection to be able to approve my foster application. I agree that if I'm unable to foster the animal(s) anymore that I will return the animal(s) and any supplies to Permian Basin Animal Advocates and try to give PBAA a 2 week period to try and find another suitable foster for the animal(s).

Date

MonthDayYear

Your name

E-mail