Cat Foster Application

First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

Email*

Home Phone*

Cell Phone

What is the best time for us to call you?*

What is your occupation?*

Please confirm your age.

How did you hear about the Greater Derry Humane Society?*

Do you own or rent your home*
Choose one: Rent Own

If you rent, have you received the approval of your landlord to have an animal*
Choose one: Yes No

If your home is an apartment or condo, please provide landlord's/condo association's name

Landlord/condo association phone

Are you the only person living in your home? *

Please list the adults that live in your home, their age, and their relationship to you:*

Do children visit your home? *

Please list the ages and how often children visit in the space below:

What animals are currently in your home?*

If you have had pets in your household in the past 5 years that are no longer with you, please list type of animal, gender, age, and why they are no longer with you.*

May a member of GDHS visit your home by appointment?*

Veterinarian's Name*

Please provide your veterinarian's address.

Veterinarian's Phone Number*

How many hours will your foster cat be alone at home each day?*

Where will your foster cat sleep at night?*

Who will be the primary caregiver of your foster cat?*

Does the primary caregiver have any previous cat experience?*

If yes, please explain:

Do you currently have a vehicle?*

Would you be willing to drive your foster animal to veterinary appointments?*

Would you be willing to meet with potential adopters to discuss information regarding your foster animal?*

Would you be comfortable giving your foster animal medications? *

Are there any limits to the amount of time you can foster? (Yes or No) If yes please provide time limit.*

When are you available to start fostering?*

Is there anything else you would like us to know about you?

By typing my first and last name below, I certify that the information I have given is true and I recognize that any misrepresentation may result in rejection of my application. This serves as my legal signature, and authorizes The Greater Derry Humane Society to verify all information provided.*

Today's Date (mm/dd/yyyy)*