First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone*

Where did you find out about us (please be specific)?

How would you prefer to be contacted?*
Choose one: Email Phone Text

Is your home a(n) *
Choose one: Apartment Single family house Single family house with acreage Duplex Townhome Mobile Home Farm

Do you own or rent your home?*
Choose one: Own Rent Live with another family memeber

Does your landlord allow pets in your home? (Home owners, please select N/A)*
Choose one: Yes No Unknown N/A

Landlord's Name, Address, Phone Number (Home owners, please enter N/A)*

Do you have a fenced in yard?*
Choose one: Yes - 4' - 5' Yes - 6' Yes - invisible fence Yes - partial fenced yard No fence

Highest level of education achieved*

Place of employment of primary adopter*

How long have you worked at your current employer?*

Special knowledge, skills, abilities, hobbies*

Please describe your prior volunteer experience (include organization names and dates of service)*

Why do you want to volunteer or what do you hope to gain from your volunteer experience?*

Have you ever been convicted of a crime? If yes, please explain the nature of the crime and the date of the conviction and disposition. (Conviction of a crime is not an automatic disqualification for volunteer work.)*

Do you have a current valid driver's license?*
Choose one: Yes No

Do you have a current and valid Auto Insurance policy?*
Choose one: Yes No

Do you have Renter's or Home Owner's Insurance?*
Choose one: Yes No

Do you have a reliable vehicle?*
Choose one: Yes No

Are you willing and able to take foster cats/kittens the their vet appointments when necessary?

Ages of children in household*

Do you currently have pets in your home?*
Choose one: Yes No

What type of pet(s) do you currently have? Please list the following for each: species/breed, age, and if they are spayed/neutered/unaltered. If none, enter N/A.*

Tell us about your experience with animals*

How long will pet be alone on an average day?*

Please list three people (only one family member) who know you well and can attest to your character, skills, and dependability. Please provide a phone number to contact them.*

Please carefully read the following information before signing this application:

All foster applications require approval from a Mitchell Animal Rescue Director and may include a home inspection. Foster animals will have the necessary shots, be spayed or neutered, or have an appointment set for spay or neuter as soon as possible. Foster animals shall be examined by a veterinarian prior to placement in the foster home. The fostering parent shall be given specific instruction for the care of the animal. All costs incurred in the feeding and housing of the animal(s) during the fostering period willl be the responsibility of the Mitchell Animal Rescue. All necessary medical care administered by Mitchell Animal Rescue’s veterinarian shall be approved by one of the Directors of Mitchell Animal Rescue and provided at no cost to the foster parent. Fostered animals that have documentation stating they have been surrendered to Mitchell Animal Rescue are the property of Mitchell Animal Rescue. No animal shall be kept by a foster parent or be given to another individual without going through the normal adoption process or foster home approval process. Foster parents shall have first choice to adopt any fostered animal providing they are within their zoning limits. Foster parents electing to adopt an animal in their care shall pay all applicable fees associated with a normal adoption. Adoption fees are waived if the foster parent elects to pay for all veterinary care including spaying/neutering, vaccination, microchipping, etc. Foster parents that choose to have their fees waived will be given a specified time by Mitchell Animal Rescue to comply with spaying/neutering, vaccination requirements. Foster animals must be surrendered to Mitchell Animal Rescue if the foster parent fails to comply with the terms of this policy. Foster parents must abide by the leash law or animal restraint laws in their city or county. All fostered animals must be secured in a fenced in area or tied out on a leash or tie out to prevent them from breaking free and getting lost, hurt, or killed. When outside, foster animals must be supervised at all times. If a foster animal does break free, the foster parent must alert animal control, police department, Mitchell Animal Rescue, and any other agency that can help with recovering the foster animal. Foster parents are responsible for any fines for running at large, disturbing the peace by incessant barking, defecating on someone’s property or any other animal law violations. Please be informed about the laws in your area. While in your care, Foster Parent assumes all responsibility of the actions of the foster animal. Any loss or death of a fostered animal must be reported to Mitchell Animal Rescue immediately. By signing this form, you agree that you have read and understand all the requirements and responsibilities for fostering a pet for Mitchell Animal Rescue.

Signature of Adopter:*

Signature of MAR Representative:

Date:*