Street Address *
Federated States of Micronesia
U.S. Virgin Islands
Zip code *
Home Phone *
What kinds of animals are you able to foster? * Cat Dog Other
Please specify species/size/age/sex, etc. you are willing to foster. *
Have you ever owned a pet? * Yes No
If yes, what kinds of animals? *
Which of these pets do you still own? *
Are these animals spayed/neutered? Yes No
Are these animals up to date on their shots? * Yes No
If you currently own pets, who is your veterinarian? *
Are there any children in the household? * Yes No
If yes, what are their ages? *
What is your living situation? * Own Rent
If renting, please provide the name and phone number of the landlord.
Do you have a fenced yard? * Yes, fenced yard No, not fenced yard
If yes, what is the type and height of the fence?
Where will the foster animal(s) be kept while in your care? *
How many hours will the animal(s) be left unattended? *
For how long would you be able to house an animal (eg. two days, a week, a month, indefinitely, etc.)? *
Are you willing to transport the animal to adoption days and/or the vet? * Yes No In most cases, depending on dates
Additional information you wish to provide?
Please provide at least two references (name, phone number).
By submitting this application you attest the information on the application is true and accurate to the best of your knowledge. * Yes, all information is accurate No, all information is not accurate
I fully understand and assume all risks involved in all activities, tasks or duties that I perform for HSNEI in my volunteer capacity. I understand the behavior of domestic animals may be unpredictable. I know they are capable of inflicting serious personal injury or death, as well as extensive property damage. Knowing the risks I agree to assume those risks and to release, discharge and hold harmless HSNEI, its volunteers, officers and directors, and its or their successors, from any liability or damages to me, my household or members of my household connected with HSNEI volunteer activities. * I agree I disagree