CVAS

How long have you lived at the above address?

Previous Address:

City:

State:

Zip Code:

Who are you employed by?

Type of animal you're interested in fostering:
Mother with babies Just kittens Doesn't matter, will foster either

Where did you learn about our foster program (check those which apply)?
petfinder.org             article in the paper        Petsmart
radio station             friends/relatives
Other:

How much time do you have to spend with the animal you are interested in fostering? Please keep in mind if you are fostering nursing kittens without a mom, they must be fed every couple of hours.

Are you familiar with caring for very young kittens with or without a mother?
Yes No
If yes, please explain your experiences.

Do you: Rent Pay Lot Rent (Mobile Home)
Own (proof of ownership may be required)

To whom do you pay rent or pay lot rent?
Name:
Phone number (including area code):

Do you live in your parent's home any part of the year? Yes No
If yes, provide parent's name:
Parent's phone number (including area code):

Is anyone in your household allergic to animals? Yes No
If yes, who is and what are they allergic to?

Where will the pet(s) be kept during the day? Check all that apply.
Garage Crate/Cage Finished Basement Unfinished Basement Inside Home, kept in a single room Inside Home, given the run of the house
Other (please explain):

Do you have an area to keep foster pet(s) away from your current pets?
Yes No N/A

Are you familiar with the laws concerning rabies vaccinations for dogs and cats?
Yes No

If fostering a cat or kittens, how would you deal with the problem of not using the litter pan or scratching, etc.?

Have you ever been a foster parent for an animal shelter before? Yes No
If yes, which shelter (please include location, i.e. town and state)?

Have you ever owned a pet? Yes No
If yes, what kind of pet?

If yes, do you still have the pet(s)? Yes No
If no, please explain:

List all the current pets living in your home or outside your home:

Name: Dog    Cat   Other:
Breed:    Sex: M    NM   F   SF

Name: Dog    Cat   Other:
Breed:    Sex: M    NM   F   SF

Name: Dog    Cat   Other:
Breed:    Sex: M    NM   F   SF

Name: Dog    Cat   Other:
Breed:    Sex: M    NM   F   SF

Name: Dog    Cat   Other:
Breed:    Sex: M    NM   F   SF

Name: Dog    Cat   Other:
Breed:    Sex: M    NM   F   SF

Name: Dog    Cat   Other:
Breed:    Sex: M    NM   F   SF

Name: Dog    Cat   Other:
Breed:    Sex: M    NM   F   SF

1. To house the foster animal(s) in sanitary conditions, which meet or exceed all minimum standards as defined by local Health, Sanitation and Humane Authorities.

2. To provide appropriate food, clean water, shelter and exercise for all animals in my care. CVAS will supply food, litter, any medications and supplies that are needed upon request.

3. I agree that at any time during the foster care period, CVAS has the right to an unscheduled home evaluation. If upon inspection, CVAS finds that inadequate care is given to the animal(s), CVAS has the right to remove the animal(s) from the premise.

4. I understand that the animal(s) shall remain the sole custody of the Cumberland Valley Animal Shelter.

5. I agree to return foster animal(s) upon request, or at the agreed upon time or when I am no longer able to adequately care for them.

6. I understand that I do NOT have the authority to place foster animal(s) in other homes or with other individuals unless permission is granted by CVAS personnel.

7. I agree to cooperate with the CVAS staff and potential adopters to facilitate placement of the foster animal(s). I understand that some animals cannot be placed into a forever home due to health and/or temperament issues.

8. I agree to immediately notify CVAS staff if the animal(s) become sick, injured, lost, or appear to have any change in condition.

9. As custodian of foster animal(s) for CVAS, I agree that CVAS will not be held responsible for accidents, injuries, or illnesses to myself, my family or the animal while performing my duties as a foster parent. I assume full responsibility and release CVAS from same.

I certify that I am at least 18 years old and the above statements are true and agree to the conditions of this application:
I confirm and agree.

**Please note that by clicking the confirm and agree button and then pushing submit, you are providing the electronic equivalent of your signature.