First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone*

Alt Email

Date*

Employer*

How would you prefer to be contacted? Email or text?*

Work phone number*

Type of pet willing to foster*
Choose one: Large dog Medium dog Small dog Puppy Full litter of pups Pregnant dog Nursing dog with puppies Adult cat Kitten Litter of Kittens Nursing cat with kittens

Have you ever adopted or fostered from a rescue or sanctuary before?

Organization name

When?

May we contact them?
Choose one: Yes No

Employer phone number

Why do you want to foster a pet?*

Do you have experience with cats/dogs?*
Choose one: Yes No

What pets do/have you owned in the last three years?

What happened to these pets?

Were your pets spayed/neutered?*
Choose one: Yes No

Name of your veterinarian*

Vet phone number*

How often do you take your pets to the vet?*

List two personal references with phone number*

Number of adults in the household*

Number of children in the household*

Age(s) of children

In what type of home do you live? *
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent*
Choose one: Own Rent

Landlord's name and phone number*

Is your yard fenced?*
Choose one: No Yard Unfenced Yard Kennel Run Yard Partially Fenced Yard Completely Fenced

If so, what is the type of fence and height

Who will care for and feed the animals?*

Where will the pet stay when people are at home?*

How many hours will the pet be left alone each day?*

While alone, where will the pet stay?*
Choose one: House Yard Garage Other

Does any member of your household have an allergy to pets?*
Choose one: Yes No

Will you be moving in the foreseeable future?*
Choose one: Yes No

If you have to move what will you do with the animal?

Have you ever had to give a pet away?*
Choose one: Yes No

If you have given a pet away, where did it go?

Will you be able to bring the pet to adoption fairs?*
Choose one: Yes No

Will you be able to attend training classes and social outings with your foster pet?*
Choose one: Yes No

Will you allow a home visit?*
Choose one: Yes No

I certify that the answers I have given are true to the best of my knowledge, and understand if they are found to be false FFLAS has the right to remove the animal from my custody.*
Choose one: Yes No

Signature*