Name *

First Name

Last Name

Date of birth *

MM

DD

YYYY

Home address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home phone

(###)

###

####

Work phone

(###)

###

####

Cell phone

(###)

###

####

Preferred method of contact

Email

Phone

Text message

Type of residence *

House

Apartment

Duplex

Condo

Dorm

Do you rent or own your home? *

Rent

Own

Fenced yard *

Yes

No

Partially fenced

Would you consent to a legally required home visit by a member of the PALS staff or board? *

By law, the State of Iowa now requires a home visit by a shelter staff or board member for new foster households.

Yes

No

I would like more information about the home visit before I decide

Have you ever fostered animals before? *

Yes

No

Have you had pets before? *

Yes

No

I have lived with pets but they weren't mine

Do you have pets now? *

Yes

No

Are all of your pets up-to-date on all of their vaccines?

If applicable

Yes

No

Not sure

Foster animal type *

Cat

Dog

Foster animal age *

Check all that you would be willing to foster (all necessary training provided)

Bottle baby

Weaned kitten/puppy

Nursing mother with kittens/puppies

Adult

Senior

Special cases

Check all that you would be willing to foster (all necessary training provided)

Unsocialized animal

Animal with behavioral challenges

Animal recovering from an injury or medical procedure

Animal with an infectious disease (such as parvo, panleukopenia, or ringworm)

Animal with incontinence

Animal with a chronic illness (such as diabetes)

Animal with a terminal illness (fospice)