Foundation for the Care of Indigent Animals

Date of Application

PERSONAL / HOUSEHOLD INFORMATION

Your Name (First & Last): Address: City: State: Zipcode: Home Phone Number: Work Phone Number: Email Address: Employer: List other adults living in your home and their relationship to you: Do any children live in, or visit, your home? If Yes, what are their ages? Is anyone in your household allergic to animals? What type of home do you live in? If Other, please explain Do you own or rent your home?

If you rent, you must have Landlord's permission to have a dog.

Please provide us with your Landord's Name: Please provide us with your Landord's Phone Number: Do you have a fenced yard? If Yes, what type of fence do you have? If Other Type, please describe: What is the height of your fence, at the lowest point? Do you have a swimming pool? If Yes, is the pool fenced?

PET OWNERSHIP INFORMATION

Do you currently own any pets?

If Yes, please provide the following information about each pet:
If No, CLICK HERE to skip to the next section.

CURRENT PET #1

Pet 1 Type (dog, cat, bird, etc.) Pet 1 Breed Pet 1 Gender Pet 1 Spayed/Neutered Pet 1 Licensed

CURRENT PET #2

Pet 2 Type (dog, cat, bird, etc.) Pet 2 Breed Pet 2 Gender Pet 2 Spayed/Neutered Pet 2 Licensed

CURRENT PET #3

Pet 3 Type (dog, cat, bird, etc.) Pet 3 Breed Pet 3 Gender Pet 3 Spayed/Neutered Pet 3 Licensed

CURRENT PET #4

Pet 4 Type (dog, cat, bird, etc.) Pet 4 Breed Pet 4 Gender Pet 4 Spayed/Neutered Pet 4 Licensed

CURRENT PET #5

Pet 5 Type (dog, cat, bird, etc.) Pet 5 Breed Pet 5 Gender Pet 5 Spayed/Neutered Pet 5 Licensed

CURRENT PET #6

Pet 6 Type (dog, cat, bird, etc.) Pet 6 Breed Pet 6 Gender Pet 6 Spayed/Neutered Pet 6 Licensed If you currently own more than 6 pets, please use this section below to provide the same details for each addtional pet: Why do you want to foster? What previous animal experience do you have? Have you ever fostered an animal before? If Yes, for whom?

Please indicate the areas you are available to foster:

(Please Note: Puppies without a nursing mother may need bottle feeding every 3-4 hours)

Size Preference: Gender Preference: Age Preference: Condition Preference: Have you cared for young puppies before? When can you start fostering?

How will you transport your foster pet(s)?

Type of Vehicle (Select YES to your appropriate vehicle type)

Small Car Medium Car Large Car SUV Van Open Truck Closed Truck Other * * Specify Other: Do you have a Pet Carrier? If Yes, what size? How many hours a day will the foster pet(s) be left alone? Where will the foster pet(s) stay when left alone? Will the foster pet(s) be allowed in the house? Describe the area you intend to keep the foster pet(s):

Please be specific (ie fenced yard, kennel, etc.)

If away on vacation or business, who will be responsible for the foster pet(s)? How will you deal with problems such as housebreaking, barking, digging, chewing, etc.? Will you need assistance with food, animal care products?

Note: With medical fund approval, FCIA will provide medical assistance.

Are you willing to interview prospective adopters? Are you able to bring the foster pet(s) to adoption sites? How did you find out about the FCIA Foster Program?

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