First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Text/Pager Email

You are interested in providing a foster home for: (Check all that apply)

Is there a particular animal you are interested in fostering?
Choose one: Yes No

If yes, name of that particular animal

Do you own or rent your home
Choose one: Rent Own

if you rent, please provide the name of the complex and your landlord's or property manager or home owner's name and phone number.

Enter your mobile phone number

Enter the email address you wish to be contacted

Do you currently have animals?
Choose one: Yes No

Current Animals: #1 Animal Name

Dog/Cat/Bird/Reptile/Other

Spayed/Neutered?
Choose one: Yes No

Vaccinations up-to-date?
Choose one: Yes No

Is this animal kept:
Choose one: Inside Only Outside Only Inside and Outside

How long have you had this animal?
Choose one: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99

#2 Animal Name

Dog/Cat/Bird/Reptile/Other

Spayed/Neutered
Choose one: Yes No

Vaccinations up-to-date?
Choose one: Yes No

Is animal #2 kept in or out?
Choose all that apply: Inside Only Outside Only Inside and Outside

How long have you had this animal?
Choose one: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99

#3 Animal Name

Dog/Cat/Bird/Reptile/Other

Spayed/Neutered
Choose one: Yes No

Vaccinations up-to-date?
Choose one: Yes No

Is Animal #3 kept in or out?
Choose all that apply: Inside Only Outside Only Inside and Outside

How long have you had this animal?
Choose one: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99

Other, please explain:

Have you ever given up a pet? If yes, please explain

How many people reside in your household, adults and children?

How many children are in the household, and what are the ages of the children in the household?

Who in the household will care for the pet

How many hours will the animal be alone during the day (include work, school, volunteering, errands, etc.)?

Where will the animal be kept when you are home?

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

What type of fence*
Choose one: Privacy Chain Link Invisible

What is the height of the fence*

Veterinarian's Name, address and Phone Number

Are you prepared to provide your foster pet with indoor shelter, adequate food, water, and attention and make acommitment to care for this animal until a permanent home can be found?
Choose all that apply: Yes No

Friends For Life Animal Haven provides all routine and emergency veterinary care through our designated veterinarians. Foster pets are not to be treated by unauthorized veterinarians unless pre-approved by your contact person. Expenses resulting from unauthorized routine veterinarian care will be the responsibility of the foster parent. I certify the information given on this form is true and complete to the best of my knowledge. I also understand that falsified information or significant omissions may disqualify me from further consideration for fostering a Friends For Life animal. Type your name and today's date*