Foster Application Step 1 of 5 20% Foster applicant name First Last Applicant Signature (list your name and date as an electronic signature) Date of Birth MM slash DD slash YYYY Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneEmail Type of house you reside in Length of time at current address Do you own or rent this property? Own Rent How many people live at residence Do you have a fenced in yard? Yes No What type and height? Do you live with parents/roomates? Can you get permission to foster an animal? Vet reference Please list all animals that live at residence (include type of animal, age, if they are vaccinated and if they are spayed/neutered)Are you at least 18 years of age? Yes No Have you ever fostered before? Yes No If so, for whom and how long ago? How many hours will the dog be left alone? Do you own a dog crate? Yes No Other preferences? (Size, age, etc)Are you willing to foster a pregnant mother and keep until puppies are born and the puppies are old enough to be adopted? (This will require at least an 8–10-week commitment) Yes No If you are willing to foster a pregnant mother and puppies, do you have a quiet, warm area where mother and pups could be contained separately? Yes No Would you be willing to foster an older dog long term? Yes No Can you foster until an adopter is found?Would you be available as a short-term foster in case of holidays, weather or emergency situations? Yes No Emergency contact (name, relationship, address & phone) Can you provide transportation to and from vet appointments, events or kennel if needed? Yes No We will attempt to provide you with an honest evaluation of the temperament of the dog we place in your foster care. Do you acknowledge that there are times when a complete history of an animal may not be known, and you may encounter some behavior problems with a fostered animal? Yes No Are you willing to work on any problems with us? Yes No Are there any circumstances or additional information that you would like us to know about?