Name:

Address:

Zip: City: So. CA only, pls

Home Phone:    Other Phone:   

Email:

Preferred contact time and location:

Are you interested in fostering (check all that apply)

Adult Cat

Kitten/teenager

Special Needs Cat

Do you live in a house or apartment?

Do you own or rent?

If rent, name and phone number of landlord:

Do you currently have any pets? Yes   No

If yes, please tell us about them:

Animal #1 Type (dog, cat, bird, etc.) For how long?

Spayed or Neutered? Yes   No Don't Know

Up to date on immunizations? Yes   No Don't Know

Where does this pet live? Indoors  Outdoors  Both

Animal #2 Type (dog, cat, bird, etc.) For how long?

Spayed or Neutered? Yes   No Don't Know

Up to date on immunizations? Yes   No Don't Know

Where does this pet live? Indoors  Outdoors  Both

Animal #3 Type (dog, cat, bird, etc.) For how long?

Spayed or Neutered? Yes   No Don't Know

Up to date on immunizations? Yes   No Don't Know

Where does this pet live? Indoors  Outdoors  Both

If you have more than 3, please describe the others here:

If you've owned other pets that no longer live with you, please tell us about them here (please tell us where they are now):

How many people live in your household? Adults   Children

Ages of the children?

Who will care for the foster pet?

How many hours will the animal be alone during the day?

Where will he/she spend those hours? (check all that apply)

Loose in the house   Confined to certain rooms Confined to one room

Confined to the Basement   In a crate  Outdoors  Don't Know

Other, pls explain

Please provide us with the name, address and phone number of your Veterinarian:

Are you prepared to provide your foster animal with long-term care until a permanent home can be found? Yes No

Heads2Tails Foundation provides all routine and emergency veterinary care through our designated veterinarians. Foster pets are not to be treated by unauthorized veterinarians unless pre-approved by your contact person. Expenses resulting from unauthorized routine veterinarian care will be the responsibility of the foster parent.

Typing your name below will serve as legal signature.

I certify the information given on this form is true and complete to the best of my knowledge. I also understand that falsified information or significant omissions may disqualify me from further consideration for fostering a Heads2Tails Foundation animal.