Foster Application - NorthEast Pit Rescue & Sanctuary, Inc.

Personal Information

By entering your information you agree that all statements in the application are made based on personal knowledge and are made for the purposes of applying to foster one or more animals through NorthEast Pit Rescue and Sanctuary, Inc. foster care program.

You furthur understand that NorthEast Pit Rescue and Sanctuary, Inc. is very concerned about the security and safety of your foster animal(s) and all the animals in its custody, as well as, its ability to keep track of all animals rescued. You Understand that NorthEast Pit Rescue and Sanctuary, Inc. will not share this information for any reason not connected to the foster care program or applicable lawsuits.

Full Name

Email Address

Street Address

City

State

Zip

Home Phone

Cell Phone

Business Phone

Preferred Time to Contact

Preferred Contact Method

Driver's License Number

State of Issuance

Employment

Employer Name

Employer Phone

Employer Street Address

Employer City

Employer State

Employer Zip

Job Title

Years Employed

Responsibilities/Duties

Number of animals you can foster?

Do you have a preference for a specific animal(s)?

If any of the animal(s) you specified are unavailable, are you open to substitutions?

If yes, what restrictions do you have on the type of animal you foster?

Where will your foster animal sleep at night?

Where will your foster animal stay during the day when you ARE at home?

Where will your foster animal stay during the day when you ARE NOT at home?

Residence Information

Do you rent or own the residence in which you live and intend to house an animal or animals?

Do you have permission to bring an animal or animals into your dwelling?

Length of Time at Your Residence

Do you have a fence?

Do you now or have you had in the last five years any companion animals at home?

Companion Animal Information

How many companion animals do you have at home?

Please provide the total number of animals you currently and/or have had within the past 5 years, including fosters.

Veterinarian's Name

Clinic Name

Clinic Phone Number

Veterinarian's Street Address

Veterinarian's City

Veterinarian's State

Veterinarian's Zip

Number of years you have worked with this Veterinarian?

Records are under the name of...

Household Information

How many children do you have at home?

Please list all of the people living in the home and/or whom will have regular contact with the animal(s) and their relationship to you.

Name

Relationship

Name

Relationship

Name

Relationship

Name

Relationship

References

Please provide two references that know you, but are not related to you.

First Personal Reference

Name

Address

City

State

Zip

Phone

Credentials (such as rescue volunteer, breeder, etc.)

Second Personal Reference

Name

Address

City

State

Zip

Phone

Credentials (such as rescue volunteer, breeder, etc.)

Consent & Agreement

By entering your name & clicking submit you agree that you:

1) Understand a NorthEast Pit Rescue and Sanctuary, Inc. representative may visit your home for a home inspection before your foster application is approved.

2) Understand that it s your responsibility to report any unusual medical or behavioral issues that may be of concern as soon as possible.

3) Understand that it is your responsibility to provide regular updates and photos of your foster(s) whether or not you are contacted by an authorized personnel of, NorthEast Pit Resuce and Sanctuary, to make sure the organization is kept informed.

4) Understand that if you are approved for fostering, you will also need to carefully read the "Foster Care Agreement," which is a separate document from this Application. The "Foster Care Agreement" represents the legal contract between a foster caregiver and NorthEast Pit Rescue and Sanctuary, Inc. You understnad that if you are approved to foster an animal, you must review the Foster Care Agreement before you can take your foster animal home. You further understand that you will be asked to agree to the terms of the agreement and sign the agreement before you can take your foster animal home.

5) You have read this application in its entirety, and you agree that all statements contained in this document are made by you and are truthful. You make this statement under penalty of perjury under the laws of the State of New York.

Full Name

Today's Date