Foster Care Application                                                               Date: _________________

 

 

Orphaned Kitten(s) _____   Orphaned Puppy(ies) _____   Pregnant Cat ______  Pregnant Dog _____

Adult Cat ______        Adult Dog _______        Military Cats _______     Military Dogs _______

 

Foster Parent’s Name:  ___________________________________________________________

 

Address: ______________________________________________________________________

 

City: _____________________________________ State: _______________ Zip: ____________

 

Employer’s Company Name:  ______________________________________________________

 

Home Phone: ____________________________ Work Phone:  __________________________ 

 

  1. Are you a part of any animal organization? __________

          If yes, which one: __________________________________________________________

   

    2.   Why would you like to foster?_________________________________________________
             ______________________________________________________________________
             ______________________________________________________________________
     

    3.    Do you live in a:  Condo/townhouse _____   Apt. _____   Duplex _____ 

           Mobile Home ______  House _______.

 

  1. Do you: rent/lease_____ or own _____.

          If you rent, is your lease monthly _____ or yearly _____.

          Name of complex and/or association: ___________________________________________

          PET POLICY: please attach a copy ____________________________________________

          How long have you been at this address? ________________________________________

 

  1. How many adults reside at this address: _____________

          Are there children in your home: __________________
          If yes, how many and what are their ages? _______________________________________

          _______________________________________________________________________

 

  1. Would there be anyone at home during the day? __________________

 

  1. Do you have any dogs and/or cats at home now? ______

          1.  Age ____ Breed ____________ Sex _____ Licensed _____ Vaccinated ____

          2.  Age ____ Breed ____________ Sex _____ Licensed _____ Vaccinated ____

          3.  Age ____ Breed ____________ Sex _____ Licensed _____ Vaccinated ____

        

          Name(s) of your pet(s):_____________________________________________________

 

          Approximate date and reason of last vet visit:_____________________________________
 

  1. Have you had other pets in the past five years? _______________

    1. Age _____ Breed ________ Year ______ Disposition _______

    2. Age _____ Breed ________ Year ______ Disposition _______

          What happened to them? ___________________________________________________

 

  1. What animal hospital/clinic do you (or did you) use? _______________________________

 

  1. Where will the foster animal(s) be when no one is home? ____________________________

 

  1. Where will the foster animal(s) sleep? __________________________________________

 

   I, _________________________, agree that all of the information which I have given above

   is  correct as written and I authorize the Prairie Paws Rescue to verify any information.

 

   Date: _________________________________

 

   Signature: __________________________________________________________________

 

   Date: _________________________________

 

   Parent/Guardian Signature: _____________________________________________________

 

   (Parent/Guardian must sign release if volunteer is under the age of 18 and is living at home.)

 

 

Foster Care Agreement

 

  I agree to the following conditions: (Please initial each.)

 

1. _____ I certify that my own pets are currently licensed and up to date on his/her vaccinations,

 including rabies.

 

2. _____ I agree to keep my pets separated from the foster animal for at least 10 days.    If the

foster animal is incubating any diseases this separation will minimize the chance of my pets

becoming  ill.

 

3. _____ I agree to keep the foster animal indoors unless accompanied outside by myself.

 

4. _____ Should the foster animal become ill while in my care, I agree to call the Prairie Paws

Rescue and take the foster animal to a veterinarian. Any charges that may incur through a private

vet will be at my expense. Deworming and vaccinations that are required during foster time will be

 provided by the clinic by scheduling an appointment.

 

5. _____ I fully understand that the foster animal is the property of the Prairie Paws Rescue. Any

decision made by the director of foster care will be followed by me, regarding the return and/or

disposition of the foster animal.

 

6. _____ I agree to return the foster animal(s) as instructed. I agree to make an appointment on the

 said date. Incoming foster animals are to come through the receiving department, the receiving

 associate will announce to the clinic of their arrival. At the appointment time, the director of foster

care will make a decision as to the disposition of the foster animal.

 

7. _____ I understand that the Prairie Paws Rescue is not responsible for any property damage

and/or injuries that may occur. Any damages and/or injuries will be my responsibility.

 

8. _____ Prairie Paws Rescue is held harmless should any animal(s) or person(s) become ill from

a foster animal. I further agree to pay any veterinary and/or medical  expenses incurred by the

foster animal.

 

Signature:_________________________________________________

      Date:_________________________________________________

      Print Name:____________________________________________

 

 

Additional Comments: 

 

 

 

 

 

 

 

 

 

  

Note To Applicant:  Please print this application, fill it in, and mail it to:

                               Prairie Paws Rescue,  P.O.Box 1114,  Jamestown, ND 58402-1114