Date
*
Today's Date
MM
DD
YYYY
Name
*
First Name
Last Name
Date of Birth
*
MM
DD
YYYY
Phone
*
(###)
###
####
Secondary Phone
(###)
###
####
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Emergency Contact
*
Emergency Contact Phone
*
(###)
###
####
How did you hear about us?
What type of animal are you interested in fostering (dog, cat, small animal)?
How many pets do you currently have? (please list name, age, breed for each):
Do you currently have any foster pets?
*
No
Yes
If yes, how many and for which group are you fostering for?
Please list any fostering experience you have previously had:
Are there any other adults in the household?
*
yes
no
Other Adult Full Names and Date of Birth.
Are there any children in your household?
*
No
Yes
If yes, what are their ages?
Please explain any restrictions on your ability to foster (time limit, dog breeds, etc.):
Any Health issues we should be aware of? (allergies to animals, weight restrictions, ect.)
Do you rent or own?
*
Rent
Own
Landlord/ Management Company Name:
Landlord/ Management Company Number:
Do you plan on moving in the next 60 days?
No
Yes
How many hours a day would your foster pet(s) be alone?
*
Less than 2 Hours
2-3 Hours
4-8 Hours
9+ Hours
Describe the noise activity in your home:
*
Quiet
Mid-Level Activity
Loud
Describe the visitor activity in your home:
*
Family Only
Mid-Level
Many Visitors
Describe the physical activity in your home:
*
Low Activity
Moderate
Active/Athletic
Are you able/willing to foster special needs animals?
*
Yes
No
If yes, what types of special needs would you be willing to help with?:
Check all that apply
Can you provide the following for your foster:
*
Check all that apply
Do you object to a representative of Great Tails Animal Rescue, visiting your home to check on the pet in your care?
*
No
Yes
Please list any requests that we need to consider:
If you currently have pets, please list your vet’s name and contact information:
Please explain any medical issues that any of your pets in your household have:
I agree that a representative of Great Tails Animal Rescue may contact my veterinarian to confirm information provided herein regarding my pets and I consent to the release of such veterinary information by my veterinarian to Great Tails Animal Rescue.
*
Do you have a fenced yard?
When you are home, the dog will primarily be:
Mark all that apply
When you are not home, the dog will be:
Mark all that apply
Would you be willing to foster unweaned puppies?
Where will the cat be kept?
Mark all that apply
Would you like to foster unweaned kittens?
Where will the small animal be kept?
Mark all that apply
Would you like to foster unweaned small animals?
