Oak Ridge Animal Shelter Foster Application

Foster Application
Thank you for your interest in fostering! Please answer all questions. This information is important to ensure that the animal you are interested in fostering is going to a safe place.

Please note: We reserve the right to refuse the ability to foster to anyone. Please be advised that we will not foster to persons who mislead or fail to provide accurate information on this application. You will be notified if your application has been approved.
Household Information:
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number
Please enter a valid phone number we can reliably reach you at.
Cell Phone
Please enter a valid phone number we can reliably reach you at.
Spouse/Partner Name

First NameLast Name
Email*
Please provide a valid email address we can reliably reach you at.
Date of birth:*
ID/Driver’s License #, State Issued:*
Ex. #123456789, TN
Are you currently (check all that apply):*

Employed full timeEmployed part timeStudentRetiredOther
How many other adults live in your home? number*
Please list their names and ages: names, ages
How many children live in your home? number*
Please list their ages: ages
Are all members of your household aware of and in agreement with you fostering? Yes/No?*
If not, please list who is not in favor: name
Do you:*

Own your homeRent your home
Is your home a:*

HouseCondoApartment
Required* Name of homeowner (if not SELF):name
Relationship with homeowner: relationship
Homeowner’s phone number: ###-###-####
Required* Name of landlord (if not SELF):name
Landlord’s phone number: ###-###-####
Does your lease allow pets? (choose one)

YesNoDon’t knowN/A
Do you have a fenced yard?*

YesNo
If yes, what type of fence? chain link, wooden, etc.
Fence height: Ex. 4 feet
Foster Information
Why do you want to foster?*
If interested in fostering a dog, what level of exercise do you prefer? (choose all that apply)

Couch PotatoShort walksVigorous walksHiking/jogging
Do you have any preferences of what type of fostering you want to do? (check all that apply)*

Socialize feral/semi-feral catsMom and litter-catsMom and litter-dogsPuppiesKittensAdult catsAdult dogsBottle feedingSick animalInjured animal/surgery recoverySenior animal/special needsFoster to adopt. (If so, also answer next question)Other
If foster to adopt, who? animal’s name
Do you have experience fostering the choices you selected in the previous question? Yes/No*
If yes, please describe your experience: blank
Have you fostered with other organizations? Yes/No*
If yes, who: Organization’s name
Vet Care
Do you provide vet care for your current animals?*

YesNoN/A
Please provide a description of what you consider to be routine vet care:*
Please provide your current or most recent veterinarian's contact information: Vet practice* Vet's phone number*
Current Pets
How many pets do you currently have? #*

Please list the current animals in your household:

	Pet’s Name	Species	Age	Spayed/Neutered?
Pet 1
Pet 2
Pet 3
Pet 4

Do your pets wear identification tags?*

YesNoN/A
Are your pets vaccinated annually?*

YesNoN/A
Do you use heartworm preventative?*

YesNoN/A
Do you use flea/tick preventative?*

YesNoN/A
Have your cats been tested for FIV/FeLV?*

YesNoN/A
Where do you keep your pets during the day?*
Where do you keep your pets at night?*
If applicable, how often are your cats allowed outside?
New Foster Pet
How will you plan to allow a dog outdoors? (check all that apply)*

Tie out/chainInvisible fenceGarageLeash walksN/A, indoors onlyLoose to roamFenced yardOutdoor penN/A
If “Loose to Roam,” please explain:
How long will you keep the animal you are planning to foster?*

Until adoptionUntil it is available for adoption (foster while it is in quarantine/sick)I am interested in adopting the animal I fosterOther
For cats, what are your intentions regarding declawing? (check all that apply)*

Declaw immediatelyRegular nail trimsTrain to use scratching postDiscourage inappropriate scratchingWait and see if declawing is necessaryWhat is declawing? Could you provide me with more information?N/A
What would cause you to return a foster? (check all that apply)*

Can’t housebreak the petPet chews or is destructivePet bites someoneDoes’t get along with my own petsToo much energyPet develops medical problemsCan’t afford to fosterChange in relationship, new partner doesn’t like pet, has allergies, etc.Not enough time to socialize the fosterLife change, such as new job, international travel, etc.
Please provide two personal references whom we may contact:
Reference #1 name* Phone number* relationship*
Reference #2 name* Phone number* relationship*
Please provide any additional information or comments we should know about you:
The above statements are true to the best of my knowledge:*

Powered by Jotform SignClear
RELEASE OF LIABILITY

(Volunteer/foster person with Oak Ridge Animal Shelter)
I, Name*hereby remise, release, and forever discharge the City of Oak Ridge, Tennessee, of and from any and all manner of action or actions, cause or causes of actions, suits, liability for personal injury or death or damages incidental thereto, including, but not limited to, medical bills, life earnings, pain and suffering, claims and demands whatsoever, in law or equity, which against the City of Oak Ridge or its employees, agents or representatives I have had, now have, or which I may have on account of my taking and participating in volunteer employment given by the City of Oak Ridge, and anything incidental thereto, or which my heirs, executors, or administrators hereafter can, shall or may have, for or by reason of any manner, cause, or thing whatsoever, from this date forward.

Furthermore, I realize the potential danger and hazard in volunteer employment, and anything incidental thereto, and therefore I hereby assume all risks and dangers to both my health and life, regardless of the nature or method of creation of such risks and dangers, and hereby bind my heirs, executors, administrators, and assigns to said assumption.
It is my intent in agreeing to the above provisions that neither the City of Oak Ridge nor any of its employees, agents, or representatives be held liable or be required to expend any money for any reason whatsoever in regard to my participation, involvement, or connection with the volunteer employment or anything incidental thereto.

Signature*
Volunteers in Police Services

City of Oak Ridge, Tennessee

Release of Information Authorization
I,   First Name*   Last Name*   , the undersigned do hereby authorize my former schools, colleges, universities, my former employers or any other party to release any and all transcripts or my grades, records of employment, documents, reports, evaluations, and other information concerning me, whether personal or otherwise, to the City of Oak Ridge and its representatives. I hereby authorize all local, state, and national law enforcement agencies to release any and all information pertaining to my arrest history and status to the City of Oak Ridge. This information is to be provided in connection with my application for volunteering with the police department. Further, I do hereby agree to waive any privileges that I may have said information furnished pursuant to this authorization. Reproduced copies of the authorization are as valid as the original copy.
Signature*
Date*
Street Address*   Address Line 2*   City*   State*   Zip*    Driver's License #*   State Issued
Date of Birth*         SSN#*
Should be Empty:

Foster Application

Household Information:

Foster Information

Vet Care

Current Pets

New Foster Pet

RELEASE OF LIABILITY