First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

Email*

Home Phone

Cell Phone

Text/Pager Email

Please tell us a little bit about yourself.*

Veterinarian's Name and Phone Number (Please call your vet asap and let them know you are giving permission for us to call and obtain a vet reference.)*

Have you ever given up a pet? If yes, please explain*

What behavior or medical issues are you comfortable or not comfortable working with? Examples but, not limited to: Special Needs, Senior, Bladder Expression, Behavioral Soiling, Over-grooming*

Please tell us about your own pets' personalities. Please indicate if your dogs and/or cats get along with others well or require specific personalities to mesh in your household. Examples might include: only gets along with males/females, needs an active personality, etc. Anything you can tell us to help guide us to making sure the right fit is placed in your home will be helpful. *

How long are you willing to foster a pet? Keep in mind that some are adopted out relatively quickly, while others may be harder to place and require a longer time in foster care. We cannot give you an exact amount of time as each situation is different.*

Have you fostered an animal in the past? If so, please state the name of the organization that you have fostered through.*

Please list and tell us about the animals you currently have living with you.*

Are your current pets Spayed/Neutered? If not, why?*

Are your current animals up to date on vaccinations and routine vet care? If no, Why not?*

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

If you rent, please enter your landlord's name and phone number*

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

How many people reside in your household*

What other skills do you bring as a volunteer? Besides fostering, what other types of volunteer activities would you like to be a part of?

How did you hear about us*

List at least two personal references. One reference may be a family member or DITR member. The other reference may be anyone but a family member or DITR member. Please be sure to include address and phone number. *

Is there anything else that we might not have asked that you feel relevant to tell us about?

I certify that the information entered on this applicant is true. Enter your name and date*