South Plains SPCA Foster Application_Final_2012

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South Plains SPCA Foster Application 2012

Form 1 Version March 30, 2012 Page 1

Note: Please fill out application completely. Any unchecked or blank spaces will mean your

application will not be given full consideration. Thank you.

Name:____________________________________________

Phone Number:________________________________

Address:______________________________ City:____________________ State:_______ Zip:_____________

Email:_____________________________________________

DL Number:_________________________ State:________

Alternate Contact: ________________________________________

Alternate ContactPhone Number:_______________________________

Number of People in the Home:________ Age of Children:__________________________________________

Do you live in a: HOUSE APARTMENT DUPLEX OTHER Do you: OWN or RENT?

Name of Landlord (Apartment): ______________________________________________

Phone Number: _______________________

Do you have a fenced yard? Yes No Type: _______________________ How tall? ___________________

What is the size of your yard? ______________________________________________

Do you have any pets? Yes No

Breed:____________________ Age:______ M F Current on Vaccinations? Y N Spayed/Neutered? Y N




What type of animal would you prefer to foster?

Dogs Puppies Cats Kittens Male Female

Small Medium Large Extra Large Special Needs


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Do you have an area where the animal can be quarantined if needed? Yes No

Are you able to transport your foster to vet appointments and adoption events? Yes No

How many animals are you willing to foster at a time? ____________

Veterinarian Name:____________________________________________________

Phone #:_______________________________________

Do you volunteer/foster for another rescue organization: Yes No

If yes which one: ________________________________________________________________

Please provide 3 references:

1. Name: _____________________________________

Phone Number: _______________________________

Email: _______________________________________

2. Name: _____________________________________

Phone Number: _______________________________

Email: _______________________________________

3. Name: _____________________________________

Phone Number: _______________________________

Email: _______________________________________


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Terms and Conditions

South Plains SPCA will provide medical care for the animal being placed in your home. Foster care

providers will provide proper food and shelter in a loving, safe environment for the foster pet. All catsmust be kept indoors. Foster care providers may not use the pet for medical research, fighting,

personal protection training or any use other than companion animal. The responsibility of the foster

pet belongs jointly to South Plains SPCA and the foster care provider. If for some valid reason the

foster pet does not work to the advantage of the foster care provider and the pet, South Plains SPCA

must be contacted for the return of the pet. A foster care provider will not place them in a new home.

South Plains SPCA is not liable for damages to property, injuries to personal pets or personal injuries

inflicted by the foster animal.

I _______ (initials) understand that SPSPCA, without notice or hearing, may terminate my

volunteer services as a volunteer at any time, with or without reason.

I _______ (initials) do agree to a criminal background check.

I have read and understood the terms and conditions and verify that all above information is

true and accurate.

Signature:____________________________________________

Date:_________________________

To be verified by SPSPCA:

State Drivers License: ________

Drivers License Number: ___________________________________

SPSPCA Representative Signature: ________________________________________________

Documents

South Plains SPCA Foster Application_Final_2012