The information provided in completing this profile will enable OPHS to find the most satisfying foster animal and experiences for you. Please be sure to complete all sections of the profile thoroughly and as honestly as possible. Current Page 1 Page 2 Page 3 Page 4 Complete Dog Foster Application ***All questions with asterisks must be answered or filled in to move on to the next page*** Applicant, First Name Applicant Email Phone (Home) Phone (Cell) Street Address City State - Select -Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Marianas Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zip Code Do you: - Select -Own Rent Do you live in a: - Select -House Apartment Mobile Home 5th Wheel Duplex Please Provide Landlord Name and Phone Number Your Age: - Select -Under 18 18 to 34 35 to 54 55 to 74 75 and over How many adults live in the home? How many children live in the home? Children’s ages Are all household members familiar and comfortable with dogs? - Select -Yes No Is anyone in your home allergic to dogs? - Select -Yes No How long are you willing to foster a dog/puppy? 1-7 Days 2-6 Weeks A few months As long as it takes to find a permanent home Describe any pets living in your home: (Type of animals, male/female, spayed/neutered, age, date last vaccinated) How would your pet(s) interact with a foster dog/puppy? Applicant, Last Name CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Next >
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