Potters Angels Rescue Foster Care Application
Home Phone Number
Mobile Phone Number
Street Address Line 2
State / Province
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
Central African Republic
Cocos (Keeling) Islands
Democratic Republic of the Congo
Turkish Republic of Northern Cyprus
Papua New Guinea
Republic of the Congo
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
Tristan da Cunha
Turks and Caicos Islands
United Arab Emirates
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Best Way/Time to Contact You
Is there an Animal you are Specifically Interested in fostering? If so - who?
Hours worked per day/week
Number of hours worked per day/week.
Other Household Member(s) Information
If there are any other adults (18+) in the home, please list their; names, age, gender and relationship to you.
If there are any children living in the home, please list their; name, age, gender and relationship to you.
Does anyone living in the home have any known allergies to animals?
Which member of the household will be the primary caretaker of the foster pet?
Home Information- please call your landlord and give your permission to check your references. Not doing so may delay processing your application
Live with your Parents/Family
Landlord Name (If you live at home with your parents, then your parents are your landlord).
Landlord Phone Number
Type of Dwelling
Single Family House
Single Wide Mobile
Double Wide Mobile
How long have you lived in your current residence?
Are you planning on moving within the next 5-10yrs? If yes, then why, when, and where to?
Do you have a fenced in yard?
Do you plan on using a.....for the dog?
Fenced in yard
Current Animals- please call your veterinarian and give permission for your references to be checked- not doing so may delay the processing of your application
What breed/type of animal do you have the most experience with?
Current Veterinarian Clinic Name and Phone Number
Are there any animals that currently live in the home?
To your knowledge, are your animals current on their rabies and distemper vaccines?
If Yes, please inform us of their; species, breed, age, gender, and how long you have had them. If the animals belong to a roommate, please give us the name of your roommates vet clinic.
Use this space to let us know all the animals you have owned in the past 10yrs. Please list their name, species, gender, age, and reason why you no longer have them,.
Have you ever had to rehome an animal to another person/family, rescue organization, shelter/humane society? If yes, please explain the situation.
Anticipated Plans/Daily Routine
Please describe your typical day
Which of the following statements would you use to describe you and your life style?
Very Low Activity Level
Where will the animal spend the majority of the day?
Where will the animal be left when alone?
How many hours per day/night will the animal be left alone?
Where will the pet sleep at night?
Here at Potters Angels Rescue we want to make sure we place an animal in your home that you and your family should be able to hand and care for. Please give us specific information on what type/breed/age/gender of animal you and your family are willing to foster for us. Also include if you are able to handle any types of behavior issues (such as food aggression, separation anxiety, shyness, house breaking issues).
List the types of behavior problems that you personally find unacceptable:
Are you comfortable fostering an animal recovering from surgery that may need medical attention or medication(s)?
What is your training style/preference? Please explain.
What is your definition of disciplining an animal?
What will you do if the animal is destructive while alone?
Why do you wish to be a foster caregiver?
What period of time are you willing to foster for?
Are you willing to allow potential adopters to meet the foster animal in your home at an arranged time?
Would you be able to transport the foster animal to and from vet appointments if needed?
Are you willing to travel to pick up your new foster animal? If yes, how far?
Are you currently fostering for any other rescue group at this time? If yes, please list the name of the group(s).
Have you fostered animals in the past?
Personal Reference #1 Name and Number
Personal Reference #2 Name and Number
Are you willing to have a P.A.R representative come to your home to perform a home visit?
Please provide any additional info that may be helpful:
How did you hear about Potter's Angels Rescue?
By checking this box I agree to allow a representative from PAR to perform a home inspection and conduct an interview with me and my family members.
Checking this box indicates I understand that Potters Angels Rescue will contact my veterinarian, my references, and if applicable my landlord. My application will be approved or denied based upon the home visit report, the information provided by my references, my veterinarian, my landlord, and my suitability, in PAR's opinion, as a potential foster family. I will be informed by the Foster Care Coordinator as to whether or not my application has been approved or denied. I am of legal age, and have the income and ability to take care of a foster animal. All statements I have made in this application are true and I understand that this application may be denied if any of the information supplied above is found to be false.
By checking this box I understand and acknowledge that my home, yard and car may be destroyed by the animal I am fostering, and that my animals may pick up diseases from time to time from the foster animal. I understand that in no way is Potters Angels Rescue responsible for this. Each animal that I agree to foster will come with a liability waiver form that I will sign upon bringing the animal into my home.
By checking this box, I am indicating that this is a valid and legal substitution for my written signature on this legal document titled "Potters Angels Rescue Foster Application".
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