DISASTER RELIEF FOSTER PARENT - RESCUE SCREENING APPLICATION

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Disaster Relief Foster Parent - Rescue Group, Shelter Screening Application

We are Paw Obligated to Check You Out!

Today's Date

Name of pet you will be fostering (if known)

Will you allow a Hurricane Pets representative to do a home visit to your home or rescue facility?

select one

Yes

Can you commit to fostering a pet for at least one year?

select one

Yes

If the above answer is no, for how long can you commit to foster the pet?

something more

Your Name

full name

Date of birth

(Over 18)

Address

City

State

Zip Code

a valid email

Home Phone #

ex: (555) 555-5555

Mobile Phone #

ex. (555) 555-5555

Employed

select one

Yes

Retired

Self Employed

Employer Address

Type of Residence

Select if you rent or if you own and type of residence.

Rent

Own

Live with parents

Live with roommates

Apartment

House

Condo

Townhome

Mobile Home

Private shelter

Rescue Group (Foster Homes)

Rescue Group Facility

Sanctuary

other

How long have you lived at your present address? Or if are a rescue group, shelter or sanctuary how long you been in business?

Are you planning to move soon

Yes

If planning to move soon, when?

Do you live in a high rise building

Yes

If checked "Yes" above. What Floor?

Do you have a balcony

select one

Yes

If yes, is your balcony screened

Yes

Do you have a backyard

select one

Yes

If yes Is your backyard fenced

select one

Yes

Landlord Name

ONLY IF YOU RENT

Landlord Tel. #

(555) 555-5555

Landlord E-Mail

Landlord permission to have a pet

select one

Yes

Landlord’s Initials for Consent to have a pet

Landlord Signature

Type and Number of pets allowed

Rescue Groups, shelters and sanctuaries. Are you a registered 501(C)(3) organization?

Rescue Groups, shelters and sanctuaries, please describe your adoption policies:

Rescue Groups, shelters and sanctuaries, please specify number of pets that you can take into your facility.

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