________________________________________________________________________
Animal Control
Foster Volunteer Form
Foster’s Name _______________________________ Date _________________________
ID / Driver’s License #_____
__________________________________________________
Address _____________________________________________________________________
Mailing Address
City
State Zip
E-mail address _______________________________________________________________
Home Pho
ne Number
_______________ Work Phone Number ________________
Cell phone Number _________________ Other Contact Number _______________
Do you own or rent the property where the dog will be kept?
Owner Renter
If renting, the apartment owner must provide a letter (to be attached to this
form) acknowledging permission to keep pets in the residence and listing
stipulations regarding size or type of animal.
Required Questions
Why would you like to participate in this program?
______________________________________________________________________________
______________________________________________________________________________
Do you own or foster additional pets? Ye
s No
Pet Name Species Sex
Ag
e Spayed/Neutered
_________________ ___________ ___________ ___________ ___________________
_________________ ___________ ___________ ___________ ___________________
_________________ ___________ ___________ ___________ ___________________
Do you have a fenced yard? Yes No
Do you plan to keep the dog indoors/on a leash? Yes No
_____ (Initial) Dog may not be sold, traded, or given away. Adoption must
follow the official process set forth by the Arkadelphia Animal Control.
_____ (Initial) Veterinarian care, food, water, and shelter will be the
responsibility of ________.
Times available for in-house interview:
M T W R F _____________________________
Do you work outside of the home? Yes No
How many hours a day are your pets home alone? ___________________________
Where are they kept when you are away from home? _______________________
Do you have children in your household? Yes No
If yes, how many? _________ Please list their ages: _____________________________
Your Veterinarian's Name _____________________ Phone Number ______________
Please list two personal references whom we may contact:
Personal Reference #1: ______________________________________________________
Phone number: __________________________ Relationship: _____________________
Personal Reference #2: ______________________________________________________
Phone number: __________________________ Relationship: ______________________
Foster Signature ______________________________________ Date ________________
Animal Control _______________________________________ Date _________________
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signature
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