Today's Date
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MM
DD
YYYY
Name
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First Name
Last Name
Age
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Spouse/Partner Name
First Name
Last Name
Other household members and their ages (including children)
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
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Phone
(###)
###
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Place of Employment
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Where do you live?
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House
Apartment/Condo
Military Housing
Mobile Home
Student Housing
How long at present address?
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Own or Rent?
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If renting, what is your landlords name?
If renting, what is your landlords number?
(###)
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If renting, any pet restrictions? If so, what are they?
Do you have a fenced yard?
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If yes, what kind of fence?
Do you have children that visit frequently?
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If yes, please include names and ages
Are the members of your household aware of your plans to foster an animal?
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Where will your foster animal sleep?
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How many hours per day will your foster animal be alone?
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Who will be responsible for the care of your foster animal?
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Do you have any health restrictions which could limit your ability to care for an animal? If yes, please describe.
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Do you have cats? If yes, how many? Do the cats live indoors and/or outdoors? Are the cats declawed? Are the cats spayed/neutered?
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Do you have dogs? If yes, how many? Do dogs live indoors and/or outdoors? Are the dogs spayed/neutered? Names/breeds/ages?
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Other Animals? If yes, list them please.
Veterinarian Name
Veterinarian Phone
(###)
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Why do you want to foster an animal?
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If the animal you wish to foster is not housebroken, how do you plan to accomplish housebreaking?
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What type of animal are you looking to foster?
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Digital Signature
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