Name:

Street Address:

City:

State:

ZIP:

Home Phone:

Cell Phone:

Email Address:

Would you like to receive our newsletter? Yes No

How did you hear about our rescue?

Veh year:

Make:

Model:

TAG#:

Currently: Own Rent

How long have you lived at your current residence?

Are you currently allowed to house animals? Yes No

Please describe the type of home you live in:

Please describe, in detail, the exterior of your home:

A home inspection may be conducted prior to your fostering. Would you be okay with this? Yes No

If no, please explain:

Do you have a pool? Yes No

Is it in-ground?

Is there fencing surrounding the pool? Yes No N/A

Are there any township or community restrictions on the type/breed/number of animals you are permitted to house? Yes No

If yes, explain:

If renting, please provide us with your landlord's contact information. Please include name and contact phone number.

What is your current age?

If you are under 21, do you currently live with your parents, and do they approve of you filling out this application? Yes No

Who will be the primary caretaker of the animal?

Adults:

Children:

Taking into consideration that most of our animals are special needs, whether it be Separation Anxiety, Blind, Deaf, Injured, Ill (Kennel cough, mange, seizures, etc.), Abused, Special diet to gain or lose weight, Senior’s or In hospice situation…nearing the rainbow bridge shortly, please answer the below questions honestly: {Note: None of our fosters needing aggressive or anger personality disorder training are ever placed within a non-professional training type of foster.} If you are applying to foster an animal with any special needs, please explain what measures you will take to accommodate the animal and also explain any prior experience you’ve had (if any) with this type of special need:

Are you prepared to give special assistance to their specific needs? (Ex: Hand feeding, crating, Not crating, Administering oral or topical medications, sterilizing, wound cleaning, minor verbal command training, minor house training, hospice comfort, etc. ) Yes No

How much time do you have to devote to your foster animal?

How long can you foster any one animal? 4 months
6 months
1 year or longer

Please check the type of animals you are interested in fostering: Nursing mothers with kittens
Nursing mothers with puppies
Litter of Orphan kittens
Litter of orphan puppies
Cat(s)
Dog(s)

Name of Dog you would like to foster:

Do you have a cage?

What size?

Would you be able to Please explain in detail how your animal will spend it’s time when outside:

Will the animal regularly be:

Within physical fence? Yes No

If yes, approx how many hours per day?

Tied out? Yes No

If yes, approx how many hours per day?

Within electrical fence? Yes No

If yes, approx how many hours per day?

Was the electric fence professionally installed? Yes No

If yes, by whom?

Leash walked? Yes No

If yes, approx how many hours per day?

Other?

Please explain:

Please describe where you will keep your animal when you are home:

Please describe where you will keep your animal when you are not home:

Where will your animal sleep at night?

How many hours a day will your animal be left alone?

When you are out of town, who will be the animal’s primary care giver?

In case of a family emergency, who will care for your animal?

What would you describe as unacceptable behaviors in an animal?

What would you do if your animal displayed these behaviors?

Would you agree that if your foster animal didn’t work out in your home at any time in the future that you would notify ONLY Pibbles & More Animal rescue and to no other party (including family) outside of your household? Yes No

If no, please explain:

Please give a brief description of why you want to foster an animal from Pibbles & More Animal Rescue?

Are all parties involved on board and willing to help with the care of new addition? Yes No *