APPLICATION TO BE A FOSTER HOME FOR PAWS ILLINOIS NFP

Please email your application

CONTACT INFORMATION:

Your name______

Address ______

Primary email address ______

Home number______

Cell ______

Are you over the age of 21? ______Current Age: ______

Spouse/partner/roommate name ______Current Age: ______

Ages of children in your home or who visit regularly ______

Are you employed? (Where and for how long) ______

Work number ______

Do you rent or own? ______

Landlord’s name and number, if applicable ______

Have you ever fostered a pet before? ______If so, for what organization? ______

PET HISTORY INFORMATION:

If you currently have pets, or have ever owned pets, please complete the following:

Veterinarian______Phone ______Address ______

How many other pets do you currently own? ______

Dogs______Cats ______Avian/Reptile ______Other ______

Where did your current pets come from? ______

Have you ever had to give a pet away? ______

If yes, what were the circumstances? ______

Are your pets up to date on: Vaccinations______Heartworm prevention ______

Are your pets spayed/neutered/microchipped? ______

If not, why? ______

If you have previously owned other pets, what happened to your last 3 pets? (List type, age, and circumstances for which you no longer own this pet)

Pet 1 ______

Pet 2 ______

Pet 3 ______

Where will your foster spend his/her time during the day? ______

______

Where will your foster spend his/her time during the evening? ______

______

Where will your foster spend his/her time when you are out town? ______

______

How long will your foster be alone, on average, without a potty break? ______

______

Do you plan to crate train? ______

If you don’t plan on crating, how will you keep your foster dog contained while you aren’t available to supervise

him/her? ______

Do you have a fenced in yard? ______

  • If yes, how high? ______
  • Is it fully or partially fenced? ______
  • Is it an electric fence? ______
  • Is it a wooden fence or chain link? ______

If you don’t have a fence, how will you keep your dog in close proximity? ______

______

Please answer the following questions:

Are you willing to work on basic obedience, which may include going to obedience training?

______

Do you understand that if you have children in your home, dogs and children must be supervised at all times? ______

Do you agree to care for this dog and provide food, water, medical care, grooming, indoor housing, and companionship while in your foster care? ______

Do you understand that this dog is a pet, and that if you cannot keep the dog you will immediately contact PAWS Illinois NFP to arrange for the dog to be picked up/dropped off at a specified location? ______

Have you or anyone in your household been convicted of a crime against animals or children?

______

* Please provide the name, email address and phone number of two (2) references. / Relative Reference

Non-Relative Reference

Relative Reference Name______Phone Number ______

Email Address ______

Non-Relative Reference Name______Phone Number ______

Email Address ______

I declare that the information I have provided in this application is complete and correct. I further declare that I am physically able to care for a foster dog. I understand the requirements and grant permission for home checks at random. I release Paws Illinois NFP from any liabilities I may incur from the fostering process.
By submitting this application you are agreeing to the above declaration.
* Please print your name again, to be used as a signature on this form.
______/ Signature:

Date: