Foster Care Application
Date: ______
CONTACT INFORMATION
NAME______
ADDRESS______
CITY______STATE______ZIPCODE______
PHONE 1)______2)______
EMAIL______
REFERENCES Please list 2 references and their phone numbers
Name______Phone______
Name______Phone______
HOUSEHOLD INFORMATION
Living accommodations Rent____ Own____ Other______
Does your lease allow pets? Yes___ No___
Landlord’s name______Phone______
Number of children in home______Ages of children______
Have they handled animals before?______
What will be your method of transportation to and from Petsmart or any veterinarian appointments?
Primary______Secondary______
How will you segregate the foster cat from your resident pets? ______
______
If so, Does this room have windows with secure screens? Yes___ No___
If no, please explain______
______
RESIDENT PET INFORMATION
PLEASE LIST ANY PETS CURRENTLY LIVING IN YOUR HOME
NAME / SPECIES/BREED / M/F / S/N / AGECurrent veterinarian’s name______
Current veterinarian’s phone______
Do any of your resident pets have any behavioral problems or chronic illnesses? Yes___ No___
If yes, please explain______
______
______
Are your pets vaccinations current? Yes___ No___ (You will be asked to provide proof of vaccinations prior to fostering)
Are your resident cats indoor only? Yes___ No___
How much time do you devote to your pets daily?______
______
FOSTER INFORMATION
Will you permit a Precious Pets representative to visit your home? Yes___ No___
Have you ever administered medications to a cat before? Yes___ No___
Are you willing to administer medications, if prescribed? :
By mouth: Yes___ No___ By injection: Yes___ No___
Will you be able to able to transport the foster cat to Chicago Emergency Veterinary Service (CVES) should an emergency occur? Yes___ No___
What kind of cat/kitten are you willing to foster?
Adult cat (over 1 year) only___ Injured/ill cat___
Weaned kittens (6 weeks & older)___ Bottle-fed kittens (requires 24/7 care)___
Kittens needing socialization___ Hospice care: Elderly ___
Mother with kittens___ FeLV+ ___
Injured/ill kittens___ FIV+ ___
How many hours will the foster cat/kitten be alone during a typical day?______
______
What will be the care arrangements when you are not at home?______
______
______
Why are you interested in becoming a foster parent?______
______
______
______
By signing below, I certify that the information provided on this application is true and I recognize that any misrepresentation of facts may result in losing volunteer privileges. I authorize investigation of all statements in this application and understand that veterinarians, landlords, other humane agencies, etc. may be contacted.
Applicant signature ______Date ______
OFFICE USE ONLY Accepted Denied Comments:______
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