Thank you for your interest in our foster program. Foster homes are a vital part of our organization. Without them, we would not be able to save as many animals as we do. Please complete this application in its entirety. A TEARS representative will contact you after it has been reviewed.

Demographics

Applicant's Full Name		Spouse's Name
Street Address		City	Zip
Home Phone		Work Phone
Alternate #		Type
Email Address

Personal Information

Are you 24 years of age or older?	Yes No	If no, state age:
Is everyone in the home in agreeance with fostering a rescue animal?			Yes No
Are there children in the home?	Yes No	If yes, what are their ages:
Have you ever fostered an animal before?	Yes No	For whom:
Why did you discontinue fostering for them?			Yes No
Please briefly tell us why you would like to be a TEARS foster parent:			Yes No

Residence Info

Current residence:			House Apartment Townhome Condo Mobile Home
Do you:			Own Rent
If you own, do you carry full home owner's insurance on your house and property?			Yes No
If you rent, what is the full name of landlord or leasing office?
If you rent, what is the phone number of landlord or leasing office?
Does the residence have a fully fenced in yard?			Yes No
1. Is the fence attached to the house?			Yes No
2. How tall is the fence?
3. What is the fence made out of?
4. What is the size of the yard?
Does the yard have adequate shelter for a dog as described by Alabama State Law?			Yes No
Describe Shelter:

Current Pets/Previous Pets/Veterinarian Info

Do you own a pet/pets now?			Yes No
How many of what type:			Dogs Cats Other
Please List:
1. Name: Breed: Age: Sex:
2. Name: Breed: Age: Sex:
3. Name: Breed: Age: Sex:

Are your present pets

Spayed or Neutered			Yes No
If no please explain why:
Current on all vaccinations			Yes No
If no please explain why:
Current on heartworm prevention			Yes No
If no please explain why:
Have you owned a pet/pets in the past?			Yes No
What happened to that pet?
Name of current veterinary clinic:			Phone #:
Name of animal/animals on record:
Name of previous veterinary clinic:			Phone #:
Name of animal/animals on record:
Do we have your permission to contact them as a reference for this application?			Yes No

Please answer the following questions honestly

Have you ever had a pet stolen?			Yes No
Have you ever had a pet poisoned?			Yes No
Have you ever had a pet killed by a vehicle?			Yes No
Has a pet of yours ever died from a disease?			Yes No
Would you allow a dog to ride in the back of a truck?			Yes No
Comments
Where are your current pets kept:			During the day: At night:
Where would the foster animal be kept:			During the day: At night:
How long on the average day would the foster animal be alone?
Would the foster animal be kept separate from your pets?			Yes No
If yes please tell why:

Foster Animal Criteria

I am interested in fostering (check all that apply):

Puppy/Kitten (6wks-6mos) Adult (3yrs+) Puppy/Kitten (6mos-1yr) Senior (7yrs+) Young adult (1yr-3ys) Litter of puppies/kittens

Special Needs: Heartworm positive Injured Pregnant Nursing

Is there a specific gender or breed or weight preference?	Yes No
Please describe:
Are you familiar with the rules and regulations in your city or county regarding specific breeds and/or limitations on the number of animals allowed at a residence?	Yes No
Often TEARS will rescue animals other than dogs and cats. Are you interested in fostering any other type of animals?	Yes No
Comments/Questions:

I certify that the information I have provided is true, correct, and accurate. I also understand and agree that falsification of any of the information is grounds to disqualify my application.