NOAH'S bARK PET RESCUE, INC.
					P.O. BOX 1486
				      ELLIJAY, GA 30540
			        E-mail: NoahsBark@ellijay.com

		             FOSTER HOME APPLICATION & AGREEMENT


Date: _________________________

Name ____________________________________________________________________

Address _________________________________________________________________________

City ___________________________________________     State ____    Zip __________

Home Phone (____) ________________		Work Phone (____) ______________

Driver's License # ____________________________	State ____

Have you been a foster care provider previously? Yes __ No __ 

For which organization did you foster? ____________________________________________

Contact: _____________________________________________  Phone # (____) ____________

Pets you currently own: ___________________________________________________________ 

Are they spayed or neutered? Yes __  No __

Are they current on all vaccinations?  Yes __  No __

How many children are in the home? ____________   Ages: __________________________

Who is your Veterinarian? ________________________________________________________

City ____________________________________		State _____

Vets Phone (____) ________________


1. All pets in my care remain the property of Noah's Bark Pet Rescue until adopted
   through approved means.

2. As a foster home for Noah's Bark, I will not take in any animal(s) on behalf of
   Noah's Bark without prior approval from an authorized intake representative.

3. I agree to a periodic inspection of my home as set forth by Georgia state law.

4. I agree to maintain adequate shelter, clean living conditions,food,water and
   human contact for the foster pets in my care.

5. I agree to obtain prior approval from an authorized representative of Noah's
   Bark for medical attention for the foster pets in my care.  Failure to obtain
   prior approval will result in my responsibility for any expense incurred.

6. I agree to make every effort to transport foster pets in my care to adoption
   sites and events or will arrange other means of transportation.

7. I agree to surrender all foster pets in my care, supplies and records upon
   termination of this foster agreement.

8. I agree to pay the adoption fee for any Noah's Bark foster pet in my care,
   should I decide to keep the pet as my own.

I, ________________________________________ 		Date_______________,
understand and agree to the terms and conditions set forth above as an approved
foster home for Noah's Bark Pet Rescue, Inc.
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Interviewed by: _______________________________________		Yes __  No __