Name and Age of Foster Parent:

Name and Ages of all people living in your household:

Address:

City:

State:

Zip Code:

Township:

County: 

Home Phone: (including area code)    

Cell Phone: (including area code)     

Email address:

How long have you lived at the above address?

Previous Address:

City:

State:

Zip Code: 

Who are you employed by?

Work phone: (including area code)    

Emergency Contact:

Name: 

Phone Number: (including area code):   

Type of Animal you're interested in fostering: Mother with babies Just kittens Doesn't matter, will foster either

Where did you learn about our foster program? (check those which apply)
petfinder.org             article in the paper        Petsmart
radio station             friends/relatives
Other:  

How much time do you have to spend with the animal you are interested in fostering? (Please keep in mind that nursing kittens without moms need to be fed every couple of hours)

What experiences have you had with caring for very young kittens with or without a mom?

Do you live in a (select which applies):
Home Apartment Mobile Home

Other:  

Please select which describes your status: Rent Pay Lot Rent (Mobile Home) Own (proof of ownership may be required

To whom do you pay rent or pay lot rent?
Name:
Phone number (including area code):    

Do you live in your parent's home any part of the year?   Yes No
If yes, provide parent's name:
Parent's phone number (including area code):    

Is anyone in your household allergic to animals?   Yes No
If yes, who is and what are they allergic to?

Why do you want to foster an animal?

Who will be in charge of daily pet care?

Where will the foster pet(s) be kept during the day? (check all that apply)

Yard Outdoor Kennel Garage Crate Basement Inside home Fenced Yard
Other (please explain):  

Where will your foster pet(s) be kept at night?

Where will your foster pet(s) be kept while at work?

Do you have an area to keep foster pet(s) away from current pets? Yes No N/A

If adopting a dog, where will he or she get exercise?

Are you familiar with the laws concerning rabies vaccinations for dogs and cats? Yes No

If fostering a cat, how would you deal with the problem of not using the litter pan or scratching, etc.?

Have you ever been a foster parent for an animal shelterbefore?    Yes No
If yes, which shelter (please include location, i.e. town and state)?

Have you ever owned a pet?     Yes No
If yes, what kind of pet?

If yes, do you still have the pet(s)?  Yes No
If no, please explain:

List all the current pets living in your home or outside your home:

Name: Dog Cat Other:
Breed: Sex:  Male Female Neutered Male Spayed Female

Name: Dog Cat Other:
Breed: Sex:  Male Female Neutered Male Spayed Female

Name: Dog Cat Other:
Breed: Sex:  Male Female Neutered Male Spayed Female

Name: Dog Cat Other:
Breed: Sex:  Male Female Neutered Male Spayed Female

Name: Dog Cat Other:
Breed: Sex:  Male Female Neutered Male Spayed Female

Name: Dog Cat Other:
Breed: Sex:  Male Female Neutered Male Spayed Female

Name: Dog Cat Other:
Breed: Sex:  Male Female Neutered Male Spayed Female

Name: Dog Cat Other:
Breed: Sex:  Male Female Neutered Male Spayed Female

Veterinarian's name, location and phone number:

I acknowledge that the Cumberland Valley Animal Shelter reserves the right to refuse foster care to anyone, with or without cause. No animal will be fostered to prospective caregivers who mislead or fail to provide accurate information for this Foster Care application:  Yes No

I certify that the above statements are true and agree to the conditions of this application:
I confirm and agree.     

**Please note that by clicking the confirm and agree button and then pushing submit, you are providing the electronic equivalent of your signature.

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