Personal Information: First Name: Last Name: Address: City: State: Zip: Home Phone: Cell Phone: Work Phone: Do you live in a: Apartment Mobile Home Condo House Other Do you own or rent? Own Rent If renting, landlord's name and phone number. Do you currently share your home with pets? Yes No Number of dogs Number of cats Have you considered how your animals will react to bringing a new animal into the house? Yes No Age: Are you comfortable sharing your home with pregnant or newly born animals? If no, skip the questions following this one in this section. Yes No Have you cared for pregnant or infant animals in the past? Yes No Please describe your experience Are you willing to recieve instruction about how to deal with infant or young animals, including care and training? Yes No Behavioral: Are you interested in fostering animals that have behavior problems? If no, skip the questions following this one in this section. Yes No Have you trained dogs or cats in the past? Yes No Are you comfortable with dogs that are considered shy? Yes No Are you comfortable with dogs that may be considered agressive? Yes No Medication: Are you comfortable with an animal that needs daily medication? If no, skip the questions following this one in this section. Yes No Are you able to give medication: In food Orally/by hand By injection Daily Routines: Are there any types of animal or breeds that you would not consider fostering? Please explain. How much time will you spend with your foster animal daily? How much time will the animal spend alone daily? What will you do with the animal when you are not at home? Applicant's Signature: By initialing below, I certify all the information provided above. I also agree that I have read the foster care guidelines, and am ready and willing to care for animals that HELP the Animals provides me. Initials: Date:
