First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone*

Alt Email

Please select the age range that best fits you.*
Choose one: Under 18 18-20 21-25 26-35 36-45 46-55 56-65 Over 65

Do you rent or own your home?*
Choose one: Rent Own

Landlord's Name

Landlord's Phone

If you rent do you have your landlord's permission?

Does your home currently have a fenced in yard?*
Choose one: Privacy Chain Link Invisible

If yes, what type and size of fencing do you have?*

Please list current veterinarian

Current veterinarian phone number

Please list a reference - only 1 being a family member (Name, Phone, Relationship):*

Please list a reference - only 1 being a family member (Name, Phone, Relationship):*

Please list all other pets (cat/dog/other species) living in your home and if they are spayed/neutered:*

If you pets are not neutered or spay, why?*

Are your pets up to date on shots and on flea and/or heartworm prevention?*

Have you previously had pets? (Please list pet's name, species, breed, age, and what happened to your pet.) *

Please check to indicate that you are aware that you must keep Wyoming County SPCA up-to-date in the event the number or status of your household pets should change.

Tell us why you choose to foster a dog?*

Have you previously fostered for any shelter or rescue organization? If yes, for what rescue and/or shelter?*

Are you willing to permit a home check by a WCSPCA representative?

How do you plan to housebreak the dog if it's not already housebroken?*

Please list anyone living in your home, their relationship to you and their age (including yourself)*

If there aren’t any children in your home, are there children who visit regularly? If yes, please list age and relationship.*

Are all members of your household aware that you will be fostering?

How long will your new pet be alone each day?*

Where will this pet be kept while you are away from home? (be specific)*

How many interactions will the animal have with visitors?
Choose one: Often Occasionally Never

What type of animal are you willing to foster? (Ex. Bottle babies, Kittens, Cats, Puppies, Dogs) Type of breed of dog?*

Tell us a little bit more about yourself and your desire to volunteer at WCSPCA*