First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County*

Email*

Cell Phone*

Please let us know what you are interested in fostering: *
Choose one: Cat Dog

Spouse/Partner:

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

Select the number of adults in your household?*
Choose one: 1 2 3 4 5 6 7 8 9 10

Supply the first and last names of the adults in your household: (put n/a if you are the only person in the house)*

Select the number of children in your household?*
Choose one: N/A 1 2 3 4 5 6 7 8 9 10

What are their ages? If no children, indicate N/A.*

Are you over 18 years of age?*
Choose one: Yes No

Do you own, rent or live with parents?*
Choose one: Live with parents Own Rent

If rent provide Apartment Complex & phone number or Landlord name & phone number. PLEASE be sure to include your apartment number. If not applicable, type N/A.*

If you live with your parents, provide their name and phone number. If not applicable, type N/A.*

Employer/Source of Income:*

How long have you been with your current employer?*

Are you a student?*
Choose one: Yes No

If yes, what school do you attend and what is your year of study? If not applicable, type N/A:*

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

Please call your vet to give them permission to speak to us ASAP.

Please list the name, species, and age of all pets in the home.

Please provide the name and phone number of the veterinarian who can provide medical history of current pets. If not applicable, type N/A.*

Approximately how many hours out of 24 per day will the pet be alone?*

Does anyone in your home have any known allergies to animals? If yes, please describe:*

Does anyone in your home smoke? If yes, please describe:*

Where will the foster spend days and nights? Do you have a separate space away from any animals in the home (describe)? *

Does your yard have a fence? *
Choose one: Yes No N/A

What Type of fence? How high? (Answer N/A if no fence is present)*

What is the usual activity level in your home (ie busy, relaxed, loud, quiet)?*

Is your availability flexible for vaccine or vet appointments as well as picking up and dropping off fosters? Please give a brief list of availability. *

Personal references - Minimum one required.

Please provide the name, relationship to you, and phone number for your references*

Other Comments

All the information I have provided is true and complete to the best of my knowledge. Should a cat or dog be placed with me, it will reside in my home as a pet. I agree to provide humane care and maintenance such as food, water, shelter, affection and veterinary care through the rescue. I agree to allow Colony Cats & dogs to retain my information for their records.*
Choose one: I agree