Foster Application Step 1 of 4 - Personal Information 25% Personal InformationName(Required) First Last Email(Required) Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home/Cell Phone(Required)Work PhoneDriver's License #(Required) Emergency contact, Name and Phone(Required) Household InformationDo you own or rent your home?(Required) Own a House Own an Apartment Rent a House Rent an Apartment Other Did you receive the approval of your landlord to have a pet?(Required) Yes No Please provide your landlord's name and phone number:(Required)Is your yard fenced?(Required) Yes No What type of fencing, what is the height? Are there any slats/openings that could allow a small dog to get in/out?(Required)Name, age, and relationship of all persons living with you (if none, write n/a)(Required)Is everyone in your home aware that you have applied to foster?(Required) Yes No N/A Is everyone agreeable to having a foster at home?(Required) Yes No N/A If no, please explain(Required) Animal Care InformationDo you have other pets?(Required) Yes No If so, please describe (type, age, sex, breed, spayed/neutered)(Required)(During the week) Hours per day that foster(s) will be left alone(Required) Less than 4 hours 4-8 hours 8-10 hours More than 10 hours (During the weekend) Hours per day that foster(s) will be left alone(Required) Less than 4 hours 4-8 hours 8-10 hours More than 10 hours While left alone, foster(s) will be(Required) Individual Crate Shared Crate In a restricted area of the home Free to roam Other Do you understand that sometimes a complete history and temperament of a rescue dog may not be known?(Required) Yes No I only want to foster an animal with a known history. Are you able to transport foster to vet and adoption events(Required) Yes No Please provide your veterinarian’s name and telephone number(Required)Do you have any concerns about fostering?(Required) Yes No If so, please explain(Required) AgreementTerms of Service(Required)By submitting this application, I affirm that the facts set forth in it are true and complete to the best of my knowledge. I understand that if I am accepted as a foster, that I am not the rightful owner of the dog and any medical decisions/re-homing decisions will be made by Kerrville Pets Alive. I understand that any false statements, omissions, or other misrepresentations made by me on this application may result in an immediate termination of the foster contract and the foster dog to be returned. Kerrville Pets Alive shall be held harmless from and against any and all claims and damages of every kind, for injury to any person or persons and for damage to or loss of property, arising out of or attributed to, directly or indirectly, the operations or performance of the above named volunteer (foster) under this agreement, including claims and damages arising in whole or part from the negligence of Kerrville Pets Alive. I agree to notify Kerrville Pets Alive of any injuries such as illness, escapes, injuries or any concerns pertaining to my foster as soon as possible. I certify that the information on this application is true. I give permission for you to contact my landlord and veterinarian’s office. Signature(Required)Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920NameThis field is for validation purposes and should be left unchanged.