Pope Memorial Frontier Animal Shelter Foster Parent Application
Name:
First Name
Last Name
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone: Home:
Format: (000) 000-0000.
Cell:
Format: (000) 000-0000.
Date of Birth:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Animals that you are interested in fostering (please circle all that apply):
Animals that you are interested in fostering
Dog
Puppies
Cat
Kittens
Pregnant Cats
Pregnant Dogs
Litter of Puppies w/o Mother
Litter of Kittens w/o Mother
Kittens w/ Mother
Bottle Fed Puppies
Bottle Fed Kittens
Feline Needing Medical Care
Canine Needing Medical Care
Canines OR Felines Needing Behavioral Training/Socialization
Do you:
Own
Rent
Housing Type:
House
Apartment
Trailer
Do you own the land that you live on?
Yes
No
If no, please list Landlord's name and phone:
How many adults:
How many children: ________ are in the home?
Ages of children:
Please tell us about the animals that are presently/recently under your care:
Name
Species
Breed
Gender
Altered
Age
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Who is/has been your Veterinarian?
Do you have an area inside to confine your fostered animal(s)?
Yes
No
If yes, please describe:
How long will a foster animal be alone per day at your home?
Have you ever brought an animal to a shelter before?
Yes
No
If yes, please describe:
Have you ever adopted or fostered for this shelter before?
Yes
No
What year?
What type(s) of animal(s)?
Have you adopted or fostered for any other shelters?
Yes
No
Please list the name of the shelter, the year, and what you fostered:
Different animals need to be in foster care for different lengths of time. What do you honestly feel is the longest period of time you would be willing to keep an animal in your home?
Foster care is a temporary agreement; realizing this fact, will you be able to remain emotionally separated and able to part with a foster animal when the time comes? Please share your thoughts:
Are you prepared to deal with the possible death of a foster animal (natural or by euthanasia? Please explain:
Please list two personal references:
Personal Reference 1 Name
First Name
Last Name
Personal Reference 1 Phone
Format: (000) 000-0000.
Personal Reference 2 Name
First Name
Last Name
Personal Reference 2 Phone
Format: (000) 000-0000.
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Are you willing to allow a member of PMFAS to visit your home?
Yes
No
For the purpose of fostering an animal, the undersigned certify that the above statements are true and complete, authorize Pope Memorial Frontier Animal Shelter, or its agents, to verify any information from the veterinarian concerning current of previous animals. Pope Memorial Frontier Animal Shelter reserves the right to determine whether a given animal is a suitable to the person, family, or lifestyle, to limit the placement of puppies or kittens under the age of 4 months to any homes with children under the age of 4 years, and to deny any foster care in the best interest of the animal(s).
Signature:
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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