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2. Foster Care Application
   
4. First Name*
5. Last Name*
7. Address1*
9. Address2
11. City*
12. State*
13. Zip*
15. Home/Cell Number*
16. Email Address*
18. Work Phone
20. Are you at least 18 years old?*

    1. Yes
    2. No
24. Have you ever foster ed for FRAS?*

    1. Yes
    2. No
26. How did you hear about the Foster Program?
28. Current Housing*

    1. House
    2. Condo/Apartment
    3. Mobile Home
    4. Other
29. Do you:*

    1. Rent
    2. Own
30. If you rent we must have Landlord Name & Phone Number
34. Where will the Foster animal(s) be kept during the day?*
36. Where will the foster animal(s) be kept during the night?*
38. Describe the animal' play and living area (flooring, bedding, furniture, etc...) *
40. Who Will be responsible for this animals care (feeding, watering, cleaning, etc...)?*
42. Length of time animal will be interacted with each day? Please check one*

    1. Less than 1 hour
    2. 1-2 hours
    3. 3-4 hours
    4. 5-8 hours
    5. over 8 hours
44. Ages of children in household*
46. Does anyone in the household have allergies to animals*

    1. Yes
    2. No
48. If yes, please explain
50. Who is your Veterinarian? *
52. Are you willing to allow FRAS to visit your home to inspect the area in which you intend to house the foster animal(s)?*

    1. Yes
    2. No
54. If no, please explain.
56. What type of animal are you willing to foster?*

    1. Puppies with mom
    2. Orphaned puppies requiring bottle feeding
    3. Puppies that do not require bottle feeding
    4. Adult dogs
    5. Kittens with mom
    6. Orphaned kittens that require bottle feeding
    7. Kittens that do not require bottle feeding
    8. Adult cats
58. Please list the animals you currently own (Breed, age, sex, spayed or neutered). *
60. Are the pets you currently own up to date on their vaccines?*

    1. Yes
    2. No
62. Have you ever had a dog impounded by Animal Control or picked up as a stray?*

    1. Yes
    2. No
64. Have you ever surrendered your own pet to a shelter before?*

    1. Yes
    2. No
68. Why do you want to foster for the Farmington Regional Animal Shelter?*
70. Would you like to be added to our list of emergency fosters? (Emergency foster care for the pets of other community members who are temporarily evacuated form their homes due to a natural disaster or other emergency)?

    1. Yes
    2. No
72. Electronic Signature*
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74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit Submit and Print

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