Foster Home Application Foster Home Application If you are human, leave this field blank. Applicant #1 First Name * Last Name * Age * Address * Address Street Address Street Address Street Address Line 2 Street Address Line 2 City City State/Province State/Province Zip/Postal Zip/Postal Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Isle of Man Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country Applicant #2 First Name Last Name Age Relationship to Applicant #1 Home Phone Number Work Phone Number Cell Phone Number Email * Best way / time to contact you Applicant #1 Name & Address of Employer Occupation Applicant #2 Name & Address of Employer Occupation Do you have any children? If so what are their names and ages? Please list the name, age & relationship of other people living in the residence. Do you own or rent? Own Rent If you rent, what is your landlords name & phone number? Do you have a fenced in yard? If yes please tell us the fence height. Please list your current pets: name, age, breed, spayed/neutered? Please list your previous pets: name age, breed, spayed/neutered? Please list all of your pets veterinarians name & phone number. All applicants animals must be up to date on vaccinations and spayed or neutered. Please include a list of all veterinarians that have seen your pets. Please call your vets office and authorize them to release medical information to Placing Paws. Reference #1 Please provide the name, relationship, phone number and e-mail address of someone who can provide thorough responses to questions about your suitability as a pet owner * Reference #2 (non-family member please) Please provide the name, relationship, phone number and e-mail address of someone who can provide thorough responses to questions about your suitability as a pet owner: * Do any members of the family have allergies to animals? If so, how are they treated? Is someone home during the day? Yes No What are the work hours of all household members? Where will your foster pet be kept during the day? Where will your foster pet be kept at night? What type of animal would you like to foster? Is there a specific sex, breed or age of animal that you would prefer to foster? Questions or comments reCAPTCHA Submit
