1. -688316-759124Foster Application <br /> DATE quot;
M/d/yyyyquot;
4/24/2011<br />In order to be considered for being a foster home you must:<br />1) be 18 years of age<br />2) or have the knowledge and consent of all adults living in your<br />household<br />Name: <br />Address: <br />Home Phone: Cell Phone: <br />Email Address: <br />Do you rent/own/other? <br />Landlords name phone number (If applicable): <br />Names and ages of everyone in household: <br />Does anyone in your home have allergies?: <br />Please list all of your current pets: <br />Are they spay/neutered and up to date on vaccines?: <br />Your Veterinarians name and phone number: <br />What types of animals are you interested in fostering?: Dogs FORMCHECKBOX Puppies FORMCHECKBOX Cats FORMCHECKBOX Kittens FORMCHECKBOX Other small animals FORMCHECKBOX If so what types?: <br />Are there any types/breeds etc. that you are not willing to foster?<br />Why are you interested in becoming a foster parent?: <br />Do you have any previous volunteer experience? Special skills or qualifications? <br />Please provide two personal references<br />By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. Prior to approval I am willing to allow a home visit and veterinarian/personal references to be checked.<br />Signature (electronic): <br />