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                                    FOSTER CARE PROVIDER APPLICATION                                back

Name:           
Physical Address:                                                                       City:                                                                  
State:                
Zip:                                                                                                                          

Mailing Address (if different):

Home Phone:
Work Phone:
Fax:       
Email:       

Have you ever fostered dogs before?   YES  NO      Have you ever fostered cats before? YES  NO

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Do you have dog(s) of your own?    YES  NO       Do you have cat(s) of your own?   YES  NO

If yes:                                                                 If yes:

Ø   Are they good with other dogs?    YES  NO       Ø   Are they good with other cats?    YES  NO  

Ø   Are they good with cats?             YES  NO       Ø   Are they good with dogs?           YES  NO 

PET HISTORY:

Do you currently have any cats?:  yes   no

      If yes, what are sexes, breed, & ages?:

Do you currently have any dogs?:  yes   no

If yes, please list age, breed,& sex for each:

If no current dogs or cats, have you owned any in the past?:

      no   yes, cats   yes, dogs   yes, cats & dogs  

If you no longer have any other pets what happened to them?

FOSTERED DOGS:

Do you have a fenced yard?                           YES    NO

If no, how would you ensure the dog gets regular exercise and tends to his toilet needs?

How long would the dog be left alone every day?

Where would the dog be when you are not at home?

Where would the dog be when you are at home?

Where would the dog spend the night?

How many dogs would you be willing to foster at a time?

Do you have any special issues/preferences for foster dogs? (such as sex, age)?      YES   NO

   If yes, please specify

 FOSTERED CATS:

How long would the cat be left alone every day?

Where would the cat be when you are not at home?

Where would the cat be when you are at home?

Where would the cat spend the night?

How many cats would you be willing to foster at a time?

Do you have any special issues/preferences for foster cats? (such as sex, age)?       YES   NO

   If yes, please specify

 CHILDREN:

Do you have children?    YES   NO

If yes,  what are their ages

ENVIRONMENT

Do you have a crate, playpen, carrier, kennel, etc.?       YES    NO

Would you be willing to purchase one?                          YES    NO

Is your home a very busy/active place?                         YES    NO

Is your home generally very quiet with little activity?      YES    NO

HOME VISIT

A home visit is required prior to anyone fostering or adopting an animal from PETPALS, Inc.

Have you had a home visit done by a PETPALS, Inc. volunteer?      YES    NO

If no, when would be a good time to schedule a home visit for you?

          Morning        Afternoon     Early evening    Specific time