Foster Care Application Your InformationName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands PhoneEmail(By providing this information, you may receive communications from Northeast Animal Shelter) Pet Owning ExperienceWhat pets are living in your home now?(List species, age, breed, sex, spayed/neutered, temperament)Are the pets living in your home all tolerant of other pets? My cat(s) are good with other cats My cat(s) are good with dogs My dog(s) are good with other dogs My dog(s) are good with cats Please explain your answer.Do you have a separate area or room in your house where you can contain a pet(s) while it is in foster care with you? Yes No Which of the following apply?(These skills are not required.) I can handle births. I know how to administer medications. I can house-train dogs/pups. I can work with challenging behavior pets. I can handle dogs over 50 lbs. (Optional) Please provide more information about your answer.Your FamilyIs everyone in your family comfortable with the idea of providing foster care? Yes No Please explain your answer.Do you own or rent your home? Own Rent What is your landlord's name and phone?Is anyone in your home allergic to animals? Yes No Please explain your answer.Do children live in your home? Yes No What are the ages of the children living in your home?Do the children in your home have experience with animals? Yes No What contact will the children in your home have with a foster pet?How many adults live in your home (including yourself)?Please enter a number from 1 to 10.What are the daily work schedules of the adults in your home who will be helping with foster care?Who will be the primary foster caregiver? Do you have a job outside of your home? Yes No While you are at work, who will be interacting with a foster pet or how long will it be left alone?List ages & applicable timesGeneral QuestionsAre you willing to take a foster pet back and forth to our shelter for medical care or adopter visits in your own vehicle? Yes No Are you willing to pick pets up at our shelter and drop them off when they are ready for adoption? Yes No For how long are you comfortable keeping the same foster pet in your home?example: 2 weeks, 1 month, 4 months, 6+ months Fostering is a temporary arrangement but it's normal to become emotionally attached to a pet. Are you certain that you will be able to part with a foster pet when the time comes? Yes Not sure Sometimes fostered pets are ill or become ill. If a foster pet becomes ill or dies while in your care, will you be able to deal with this? Yes Not sure What type of pets would you like to help care for?* Cats Dogs Small Animals Check all that applyOptional Pregnant cat and its litter (usually for 3 months) Unsocialized Cat or kitten (usually for 2-4 weeks) Orphaned kitten(s) who need bottle-feeding (usually 3-6 weeks) Cat/kitten waiting for surgery (usually 2 weeks) Cat/kitten needing medical care (usually 2 weeks) Litter of orphaned kittens Recently spayed or neutered cat Check all that applyOptional Pregnant dog and its litter (usually for 3 months) Dog/puppy needing medical care (usually for 2 weeks) Shy/Unsocialized dog or puppy (usually for 4-6 weeks) High arousal behavior dog/puppy (usually for 2-4 weeks) Reactive/Resource guarding dog/puppy (usually 2-4 weeks) Litter of orphaned puppies Dog fosters please list size, age or breed restrictions.example: under 25 lbs, under 70 lb, under 4 months or 1-5 years.Dog fosters: What situations would interest you?Check all that apply Weekend Away (teens & adults needing a break from the shelter) Adoption Ambassador (longer term foster for teens & adults) Finishing School (pups & teens needing socializing) Getting To Know You (teens & adults with unknown history) Roving Rovers (field trips with teens & adults) Is there anything else you would like us to know about you?ReferencesPlease provide name and phone number for a friend or neighbor who can confirm your experience with animals.What is your veterinarian's name and practice name?CAPTCHA Δ