| PERSONAL DATA |
| Title: |
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Mr.
Mrs.
Ms. |
| Name: |
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| Street: |
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| City: |
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| County: |
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| State: |
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| Zip: |
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| Day Phone: |
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| Evening Phone: |
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| Email: |
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| Over 18 years of age? |
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Yes
No |
| HOUSEHOLD INFORMATION
- Living Arrangements: |
| Do you live in a(n): |
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| Do you: |
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Own
Rent |
| Does your lease allow pets: |
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Yes
No
N/A |
| Landowners Name: |
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| Daytime Phone: |
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| Do you have a securely fenced yard? |
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Yes
No |
| Height of fence: |
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| Type of fencing: |
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| Do you have screens on your windows? |
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Yes
No |
| How many adults in your household? |
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| How many children? |
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| What are their ages? |
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| Have they handled animals before? |
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Yes
No |
| If yes, what species? |
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| Any allergies? |
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Yes
No |
| If yes, how will you handle? |
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| PERSONAL PET INFORMATION |
| Do you have any pets now? |
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Yes
No |
If yes, how many?
Please name Breed, Sex, Spayed/Neutered, Age: |
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| Who is your current veterinarian? |
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| Vet's Phone Number: |
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| Are your pet's vaccinations current? |
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Yes
No |
| Do your pets have any behavioral problems or
chronic illnesses? |
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Yes
No |
| If yes, explain: |
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| Where do your pets stay? |
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| How much time do you devote to your pets on a
daily basis? |
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| If you have no pets now, have you had pets before? |
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Yes
No |
| If yes, what type of pet? |
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| Where are they now? |
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| GENERAL INFORMATION |
| How did you hear about the ACAWL Foster Care
Program? |
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| Would you permit an ACAWL representative to visit
your home |
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Yes
No |
| Can you attend scheduled meetings or occasional
training sessions related to the Foster Care Program? |
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Yes
No |
| If no, why not? |
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| Have you ever administered medications to a dog
or cat before? |
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Yes
No |
| Have you ever participated in canine obedience
training? |
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Yes
No |
| If yes, where? |
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| What pet supplies do you have? (ie litterbox,
crate, grooming tools) |
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| FOSTER INFORMATION |
| For what length of time can you foster an animal?
(days/weeks) |
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| Are you willing to foster an animal until it
is permanently placed/adopted? |
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Yes
No |
| How much time daily would you have for a foster
animal? |
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Do you have an indoor area to confine the ACAWL
animal?
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Yes
No |
| If yes, please describe: |
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What kind of animal(s) are you prepared to foster?
(Please check all that apply) |
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| ADDITIONAL QUESTIONS |
| How would you feel if it were decided that the
animal that you were fostering needed to be euthanized due to
disease or behavioral issues? |
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| ACAWL is developing an Emergency Response Team
for coping with disaster situations (wild fire, flood, earthquake,
etc) Are you able to participate in this type of team by fostering
owned annimals until thay can be reunited with their families? |
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Yes
No |
| What kinds of animals could you house in an emergency
situation? |
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| Is there anything that you would like us to know
about you and your family or resident pets? |
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| Knowing that some rescues are prone to being
escape artists when stressed or scared, are you willing to keep
an animal owned by ACAWL on a leash at all times when in an unfenced
or unenclosed area? (This includes hiking, walks, etc) |
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Yes
No |
| Are you able to keep cats indoors or in an enclosed/escape
proof area? |
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Yes
No |
| THINGS TO CONSIDER |
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Completion of this application does
not necessarily guarantee acceptance into the program. You
will be contacted to schedule a home visit to inspect your
property prior to sending an animal into your care. |
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