Foster Application

Foster Application

Thank you for your interest in our foster program!
Adult Name*

First NameLast Name
Birth Date (Must be 18 Years old)*

MonthDayYear
Adult Name (additional i.e a spouse or roomate)

First NameLast Name
Staff: Approved or Denied?
Staff Notes:
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you rent or own?

RentOwnOther
Phone Number*

Area CodePhone Number
Is text ok?*

YesNo
E-mail*
Do all humans in your household fully support fostering?

YesNo
What type of animals are you interest in fostering?

(Please check all that apply)
Dogs

Adult (Sick/Injured)Adult (Behavior)Adult (Under Socialized/Shelter Stress)Puppies (Eating Solid Food)Bottle Fed PuppiesPregnant or NursingHospiceNot interested in Fostering Dogs
Cats

Adult (Injured/Sick)Adult (Behavior)Adult (Under Socialized/Shelter Stress)Kittens (Eating Solid Food)Bottle Fed KittensPregnant or NursingHospiceNot interested in Fostering Cats
Other

RabitsSmall RodentsReptilesOther
Do you have a preference of a specific breed, size or gender?

YesNo

Current Pets

Tell us about your home!

	Answer
How many adults live in the home?
How many children live in the home?
Names and ages of children in the home:

As a foster parent, you may have an animal in your care for a short period (1 Week) or an extended period (as many as 3 months or more). This amount of time is subject to change depending on circumstances at the shelter. If you know that you will be on unable to care for your foster during the period you are being asked to foster, please tell Midwest Animal ResQ as soon as you know. This will allow us to find the most suitable temporary accommodations for your foster animal(s).
By signing this form, you agree to the above statements and certify that the answers given above are true*
Please type your name above
Should be Empty:

What type of animals are you interest in fostering?