Foster Application Foster Application Primary Applicant* First Last Phone*Email* Secondary Applicant* First Last Any additional responsible adults need to be listed in this section - this could be a spouse, domestic partner, adult child, etcPhone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Years at this address*Persons In Household* Please list full names and ages of any other adults living in the house. This includes renters.Does anyone in your home have allergies? Please explain*What type of residence do you have?*HouseApartmentCondoDuplex/Multi UnitMobile Home - rental propertyMobile Home - owned propertyDo you own or rent your residence?*OwnRentStaying with Friends or FamilyCondoHousing with Others*Please explain. Is this temporary or permanent? If temporary, please explain further.Does your property managment or HOA rules restrict the type or number of animals allowed?*YesNoAnimal restrictions:*Please explain restrictions and or covenants. Home Description Cats Dogs Children Fenced Yard Other animals Additional Information:* Pawlease give more details on the previous question. Name, age, species, and vaccine/titer dates of all pets, ages of all children, height and type of fence, etc. Veterinary Reference*Please give us the name and phone number of your veterinarian. References will be checked.Have you ever fosterd an animal before?*If so describe types and ages of animals as well as the organization(s)Tell us why you want to be a foster:* Tell us what qualifies you to be a foster:* How long are you willing to foster?*Foster Preferences* Puppies Dogs - any Dogs - female Dogs - male Senior Pups Kittens Cats Bottle fed Special needs - behavioral Special needs - medical Special needs - hospice Mom & litter of puppies Mom & litter of kittens Please click all that apply. For example if you can foster kittens that need bottles, click both kittens and bottle fedAre you able to assist with any of the following?* Transporting to Vet Transporting to adoption events Meeting families for meet and greet Providing food and/or basic essentials Quarantine space for sick or injured animals None of the above (Note: not clicking options will not disqualify you to foster, but simply lets us know what each placement can provide)Are you comfortable providing medication if necessary?* Topical Oral - Pills Oral - Liquid Eye drops or ointments Injections None of the above (Note: not clicking options will not disqualify you to foster, but simply lets us know what each placement can provide)Pawlease tell us the care you are comfortable providing* Bathing Grooming Clipping nails Housetraining Exercising a pup Socializing shy/scared animal Crate training None of the above (Note: not clicking options will not disqualify you to foster, but simply lets us know what each placement can provide)Where will the foster animal be kept during the day?*Where will the foster animal be kept at night?*Where will the foster animal be kept when you are not home?*How long will the foster animal be left alone? Pawlease be specific*What arrangements will you make if you need to be gone for a long period of time or go out of town?*What type of exercise will you provide for your foster?*EmployerPhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Reference*Non-relatedRelationship*PhoneReference*Non-relatedRelationship*PhoneDrivers License # & State*Signature*Please enter your legal name. By entering such you agree this constitutes as your legally bounding electronic signature, and you agree that all information completed in this form is true and correct to the best of your knowledge. By signing this form, I/we acknowledge that the information on this form is true and correct. I/we agree to all provisions indicated on this form. If my/our request for fostering is approved and later My Name Is Milk discovers the above information is not true or correct, this application becomes null and void, and because of my breach of contract, My Name Is Milk reserves the right to remove the foster pet from my home, and I will be held responsible for any associated legal costs incurred as part of said reclamation process. In order to ensure the best foster homes for our rescued pets, we reserve the right to deny any foster application. We will disclose any medical or behavioral issues that are known to us. Please understand we are not veterinarians and cannot guarantee the health or behavior of any animal you choose to foster. You agree to hold My Name Is Milk harmless of all incidents.Bark to us! Tell us anything you think would be important or helpful for us to know! You may also include questions for us!Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920