First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Text/Pager Email

What is your date of birth? (**We DO NOT adopt or allow someone to foster under 21 years of age**)*

Do you own your home, rent your home or live with your parents? *
Choose one: Live with Parents Own Rent

If rental, is it seasonal?
Choose one: Yes No

If renting, please enter your landlord's name and phone number. If you are living with family/parents please provide a contact for the home owner. Enter N/A if this does not apply*

Do you currently have any pets?*
Choose one: Yes No

If yes, please provide the name & address of veterinarian.*

Name, type of animal, age and gender for current pets.

Are these pets up to date on their shots?
Choose one: Yes No

Are these pets Spayed/Neutered?
Choose one: Yes No

If yes, list pets previously owned. Please include name, breed, gender and what happened to the pet.

Have any of your animals ever been picked up by animal control? If yes, when?*

Have you ever surrendered an animal to animal control? If yes, when?*

Will the animal you are looking to foster be kept inside or outside?*

Please list all members of your household other than yourself. Please include their relationship to you and their ages.

Please provide NON-FAMILY reference, including name, phone # and their relationship to you.*

I, hereby acknowledge the following policies and agree to abide by them during the entire time I am fostering dogs for LCAR. I understand that my role is solely as a temporary home, and that the placement of any dogs I foster will be conducted by LCAR. It is the job of an LCAR representative to review and interview potential adopters, BUT as the foster, I will make the cat available to be shown.*
Choose one: Yes No

I understand that I am personally responsible for any and all financial expenses that I incur in my efforts to foster cats for LCAR. Although LCAR may choose to reimburse my expenses, I agree that each expense must be supported by receipts, must be pre-approved by the LCAR Rep, and any expense over $100 for a single cat must also be pre-approved by the Board of Directors. I accept full responsibility for any expenses incurred by me that fall outside of approved expenditures. I will always remember that I represent a nonprofit organization and in no way can profit from any activity related to the organization.*
Choose one: Yes No

I understand that LCAR cannot guarantee or be held responsible for the temperament, behavior, or health of foster cats that I may handle. I am aware that foster cats may cause damage to my personal property, other pets, and humans and agree sole responsibility for these occurrences. I will keep cat/s securely contained at all times while in my care.*
Choose one: Yes No

I understand that it is my decision to foster cats for LCAR. I will not hold LCAR liable for any damage, injury or harm caused directly or indirectly through my fostering activities with LCAR. I carry insurance coverage in the event of personal or liability damages resulting from fostering animals for LCAR.*
Choose one: Yes No

Please provide Drivers License #, State of issue and Expiration date.*