Address City _State Zip

Daytime Phone Evening

E-mail _______________________________________

I am willing to foster the following:

£ Cats £ Kittens £ Nursing Cat w/ kittens

£ Dog £ Puppies £ Nursing Dog w/ puppies

Do you own or have you ever owned a pet? £ Yes £ No

What type and how many animals do you currently have in your home? ____________________________________________________

Are the animals currently in your home spayed or neutered? £ Yes £ No Why not?

Who is your local vet? ___________________________________________Phone #

May we contact your vet as a reference? £Yes £ No Why not?

Do you own or rent your home? £ Own £ Rent

If you rent, who is your landlord? _____________________________________________________________

What is your landlord's phone number? _________________________________________________________

Please describe the general area where the animal(s) you are fostering will be kept:

____________________________________________________________________________________________________________Do you have children and what are their ages? £ No £ Yes Ages

Have you ever provided foster care to animals before (this applies to any organization)? £ Yes £ No

Are you willing to allow the Homeless Pets Foundation to visit the animal(s) at your home? £ Yes £ No

*For example, in order to take a digital picture for the Homeless Pets Foundation web site.

If you bring additional animals into your home, will you still comply with all animal control laws and zoning ordinances?

£ Yes £ No £ Not Sure

Frequently, we try to have animals adopted directly from a foster home:

Can a prospective adopter call you regarding your foster animal? £ Yes £ No

Can they visit your home to see the animal? £ Yes £ No Why not?

What period of time are you willing to foster until the pet in your care gets adopted?

References that can attest to your ability to care for animals:

1. Name/Phone Number: ___________________________________________________________________________

2. Name/Phone Number: ___________________________________________________________________________

As a foster parent you will be required to keep your foster dog(s) on a leash or enclosed (within a fence adequate for the animal or in a home) at all times. Foster cats must be kept indoors at all times. By initialing below, you acknowledge that you will abide by these provisions. Initial: ____________

As a foster parent, you will have an animal in your care for 1 week. This amount of time is subject to change depending on circumstances, and only when approved by a Homeless Pets Representative. If you know that you will be on vacation during the period of time you are being asked to foster, you are obliged to inform the Homeless Pets Foundation. This will allow us to find the most suitable temporary accommodations for your foster animal(s).

The Homeless Pets Foundation will pay for all necessary vet care only at Town and Country Veterinary Clinic, 770-971-1556, in Marietta, GA, including appropriate vaccinations and spaying and neutering. An authorized member of the Homeless Pets Foundation must approve any vet care in advance. Failure to obtain proper approval prior to obtaining additional vet care may result in your not getting reimbursed.

While you are caring for a foster animal(s), we may call you from time to time to check on the animals’ progress and address any concerns you may have. The Homeless Pets Foundation reserves the right to remove the animal(s) from a foster home if we have any reason to believe that the health or welfare of the animal(s) is in jeopardy. If for any reason the foster parent cannot fulfill their fostering duties, the animal(s) must be returned directly to a representative of the Homeless Pets Foundation. During the foster period the animal remains the property of Homeless Pets Foundation.

If the foster parent decides to adopt the animal they are fostering, they must submit an adoption application and be subject to the adoption approval process and appropriate adoption fees -no exceptions. IF A FOSTER PARENT IS NOT IN CONTACT WITH A HOMELESS PETS REPRESENTATIVE WITHIN 1 WEEK OF FOSTER DATE, THE HOMELESS PETS FOUNDATION HAS THE RIGHT TO CHARGE THE FOSTER PARENTS’S CREDIT CARD FOR THE ADOPTION FEE ($125 DOGS/$95 CATS) PLUS A PENALTY FEE OF $125.00 FOR DOGS (FOR A TOTAL OF $250.00) ANS $95.00 FOR CATS (FOR A TOTAL OF $190.00). Initial____________

By signing this form, you agree to the above statements and certify that the answers given above are true:

Signature ________________________________________________________Date_____________________
Credit Card Number                                                                                       Exp Date
Georgia Driver’s License #                                                                              Exp Date

Foster Care Checklist: The following was provided to me to assist with my ability to foster the Homeless Pets

Foundation pet. All items will be returned to the HPF upon adoption or relinquishment of said pet. If item(s) are not returned you will be charged accordingly: Initial_________

Dog Crate ($125)

Dog Bed ($30.00)

Cat Carrier ($30)

Medication (TBD)

Leash $10.00

Food Bowls $10.00

Cat Bed $15.00

Other

Witness: ________________________________________________________ Date