Newman Nation: Senior Pets United Foster Application
Please complete all questions to help us best match you with a senior foster pet.
Name
*
First Name
Last Name
E-mail
*
Primary Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
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Poland
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eSwatini
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Western Sahara
Yemen
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Other
Country
What is your current residence type?
*
House
Townhome
Condo
Apartment
Other
Do you...
*
Own
Rent
Other
Do you have a fenced-in yard?
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Yes
No
If you lease, please provide your landlord's name and contact information.
Marital status:
*
Please provide the names, ages, and relationship of all members in your current residence:
*
Does anyone in your residence have pet allergies?
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Yes
No
If yes, please explain.
Are you currently employed?
*
Yes
No
If yes, please provide the name of your employer and the hours you work.
*
Is anyone home during the day?
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Yes
No
Sometimes
Please list the dates or tentative dates of any travel plans in 2018.
*
Please list all current animals in your residence (for each, provide their name, species, gender, breed, age, and if they are spayed or neutered.
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Please name your most recent veterinarian that we can contact for a reference.
*
Your veterinarian WILL be contacted for a reference. To be proactive, you can let them know ahead of time to expect a call and can give them permission to release information.
Phone Number
*
Do you have a current tetanus vaccination?
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Yes
No
Please explain why you are interested in fostering a senior animal.
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I am interested in fostering
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Cats
Dogs
Either
I am interested in fostering the following:
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Senior
Geriatric
Hospice
Are you willing/able to foster an animal that is sick?
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Yes
No
Other
Are you willng/able to foster an animal with a disability? (ex. blind, deaf, incontinence, mobility impairments)
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Yes
No
Other
Are you willing/able to foster an animal that requires a specialized diet?
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Yes
No
Are you willing/able to administer medication to an animal?
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Yes
No
Willing to learn how
Do you have the means of transportation to bring the animal to a local veterinarian?
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Yes
No
Are you and any members in your residence emotionally able to deal with the possible health decline or unexpected loss of the foster animal?
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Yes
No
Other
How long are you willing/able to commit to fostering an animal?
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Please keep in mind that by accepting a foster into your home, you are making a commitment to that animal. If things do not work out, immediate alternative placement may not be available so prepare to handle the situation.
Would you be interested in being a Forever Foster for a senior cat or dog who might have disabilities, behavioral issues or need hospice care? (Note: Newman Nation: Senior Pets United would continue to cover the costs of any needed veterinary care for the rest of the animals' life)
Have you ever fostered an animal for another organization? If yes, provide the name.
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Newman Nation: Senior Pets United does its best to screen an animal's temperament, but cannot warrant the health or behavior of any foster animal(s). I agree that (a) I will allow home visits from Newman Nation: Senior Pets United representatives, and (b) this animal is non-transferable, and will stay in the above home until Newman Nation: Senior Pets United finds a permanent home for him/her. I further understand that only Newman Nation: Senior Pets United and its representatives will make a decision regarding permanent placement of this pet and that Newman Nation: Senior Pets United has the right to reclaim this pet at any time. I agree to notify Newman Nation: Senior Pets United immediately of any kind of problem concerning this pet that arises. I understand that while Newman Nation: Senior Pets United may make recommendations concerning how to deal with this animal on a daily basis, including quarantine, training, etc, these things are under my control unless Newman Nation: Senior Pets United gives explicit instructions. I therefore take full responsibility for any damage this animal does to my living area, pets, belongings, or myself with the understanding that these things occurred because I did not properly protect my living space, pets, belongings, or myself from this animal. If, in the future, I would like to adopt this pet as my own companion, Newman Nation: Senior Pets United will give my home first priority over other adoption applications. I have agreed to the above and understand that if this foster situation does not work out for any reason, the pet will be returned to Newman Nation: Senior Pets United representatives. By signing this form, I certify that the information provided above is true and correct.
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I agree
Signature
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Signature date
*
Submit
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