First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone*

Cell Phone*

Please list all people in your home. Include Name, Age and Relationship*

Has everyone in the home agreed to adopt/foster a dog or cat? If someone does not please elaborate.*

Do you Own or Rent Your home? If you rent, enter your landlord's name and phone number:*

What type of home do you live in?*
Choose one: Apartment Duplex Other Single Family House Townhouse

Do you have a fenced in yard? If yes, please include fence type and height.*

Do you live in a high traffic area?*

Do you have a pool or Jacuzzi/spa? If yes, how is it guarded? Is there a separate fence, deck, ladder, or cover around it?*

Name of Employer: Do you work FullTime or Part Time:*

Please list all current Pets? Age? Sex? Neutered? Type/Breed? How do they get along with other animals? How many years have you had them?*

Please list all previous pets and age? Why do you no longer have them?*

How will you exercise the dog/cat? (Walk, Run, Hike, Bike, Backyard Play, Toys?) Who will be responsible?*

Who is your current Veterinarian? List there phone number and any previous/relevant vets if you use multiple vets? Please contact them and give permission for a refence check to be done. *

4 Paws Sake, PA has a strong policy on spaying and neutering. Having your pets altered indicates that you are aware of the tragic over-population issue. If you have a special circumstance on why your animals are not altered, please write a short explanation here:

Do you use Flea/Tick Prevention?*
Choose one: Yes No

Why do you want to adopt/foster a dog or cat?*

Please describe your experience with the type of animal you are applying for. Including the length of time you have been working with dogs/cats. If you have worked with other rescues please list the group and include when. Please include any training experience you have and any experience you have with behavioral issues*

Where will the animal sleep?*

Where will the animal be kept when you ARE home? Where will they be kept when you are NOT home?*

How many hours will the dog or cat be left alone during the day

Are you aware and willing to commit to keeping this animal for an extended period of time? Fosters can have an animal for months while the correct placement is found, are you ok with possibly keeping and caring for the animal for awhile?*
Choose one: Yes No

Please list 2 references that we may call*

Any Additional Comments?