Foster Parent Application Application Date {other:date}

Animal Information

Type: {field:animal_type} {field:a_if_other} Frequency: {field:foster_fx} {field:other_fx}
Criteria: {field:animal_criteria} {field:criteria_other}
Problems: {field:animal_problems} {field:problems_other}

Animals Fostered

Name-Note1:{field:animal_1_name}-{field:animal_note1} Name-Note2:{field:animal_2_name}-{field:animal_note2}
Additional Notes: {field:fostered_additional_notes}

Prospective Foster Parent Information

Name / Age (1st Adult): {field:firstname_1} {field:lastname_1} - {field:age_adult_1} Years
Name / Age (2nd Adult: {field:firstname_2} {field:lastname_2} - {field:age_adult_2} Years
Physical Address: {field:address_p1} {field:address_p2} {field:city_p} {field:state_p} {field:zip_p}
Mailing Address {field:mailing_address_same}: {field:address_m1} {field:address_m2} {field:city_m} {field:state_m} {field:zip_m}
Phone: {field:phone}             Email: {field:email}
.. Do you Rent or Own: {field:rent_own2} a {field:housing_type}         If you rent, are pets permitted {field:pets_permitted}
.. How many adults live in your house? {field:nbr_adults} How many children? {field:nbr_children} Ages of children? {field:child_ages}
.. Do any family members have allergies to domestic animals? {field:allergies}   If so can they be around pets? {field:allergies_contact}
.. Are all family members aware you are considering a pet? {field:knows_considering_pet}

Pet Environment

.. Do you have other pets? {field:other_pets_yn}   {field:pets_current}
     How many of your pets are spayed/neutered? {field:pets_s_n}
.. Is your yard fenced? {field:fenced_yard}   Wireless fence? {field:fenced_wireless} Outdoor Cover?  {field:outdoor_cover}  Do you have a crate?  {field:have_crate}
.. Hours the pet will be alone daily? {field:care_hours_alone} Where will the pet sleep? {field:sleep_area}
.. How will you handle toilet duties? {field:toilet_duties}

Volunteer Experience

Have you ever volunteered at an animal-related organization? {field:volunteer_yn}
Volunteer duties: {field:volunteer_exp_duties}

References

Landlord/Rental Agent: {field:ref_landlord}  Phone: {field:ref_landlord_phone}
Your Veterinarian: {field:ref_veterinarian}  Phone: {field:ref_vet_phone}
Personal Reference: {field:ref_personal}  Relationship:  {field:ref_personal_rel} Phone: {field:ref_personal_phone}

Application accepted by: (AHASV Shelter Personnel) Date:

AHA-SV PO Box 654, Thayne, WY 83127 Hotline 307-883-PETS (7387) www.luckys.place