Sunday, September 05, 2010
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Sunday, September 05, 2010 |
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FAX TO 815-209-2497 or Copy and paste into microsoft word
and/or email to Info@Pawshs.org
Foster Parent Application PAWS Humane Society
Name: ______________________________________________________________ Address: ____________________________________________________________
City____________________________State___________________Zip_________
Home Phone: ______________________________________
Work Phone: _______________________________________
Other Phone: __________________________
Email: _________________________________________________
Which kind of animals would you be interested in fostering?
TYPE: CAT DOG BOTH OTHER
SEX: MALE FEMALE BOTH
SIZE: SMALL MEDIUM LARGE ANY
AGE: Less than 1 yr 1-5 yr 5 yr and older ANY Describe why you would like to be a foster parent:
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Do you have any experience with very young, ill, injured and/or unsocialized animals? Yes or No(circle one)
If Yes, please describe:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Where will the foster animal be kept? __________________________________________________________________ How long will they be unattended throughout the day? ________________________________________________ What is your housing status? Own Rent Other (circle one)
Rent or Other:
Landlords name ___________________________________________
phone ______________________
Do you have a fenced yard? Y or N How high is it at its lowest point? _______________________________
Do you have children in your household? Y or N If yes, what are their ages?______________________________________________________________ Please list current animals in your household:
Are your pets indoor or outdoor pets? __________________________________________________________________
Are your pets good with other animals? ________________________________________________________________
Veterinarian's Name & #: _______________________________________________________________________________
Name and Phone # of 2 personal references
When are you available for an in-home interview? _______________________________
I certify that the above information is true and correct. I understand that any falsification of the above information may be grounds for denial of this application or termination of my volunteer status. I acknowledge that this application remains the property of
PAWS Humane Society. I authorize PAWS to conduct an on-site inspection of the premises where the animal(s) will be kept.
Signature: ____________________________________________ Date: __________
APPLICATION MAY ALSO BE SENT TO:
PAWS
PO BOX 7722
Rockford, IL 61126
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