| Foster Home Application |
| Questions marked by * are required. |
| 1. |
Applicant: *
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| 2. |
Co-Applicant:
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| 3. |
Driver's license number: *
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| 4. |
Driver's license state: *
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| 5. |
Driver's license expiration date: *
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| 6. |
Age (must be 25 years or older. ID Required): *
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| 7. |
Address 1: *
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| 8. |
Address 2:
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| 9. |
City: *
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| 10. |
State: *
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| 11. |
Zip Code: *
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| 12. |
Phone: *
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| 13. |
Other Phone:
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| 14. |
Email Address: *
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| 15. |
Occupation: *
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| 16. |
Employer: *
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| 17. |
Name of pet you are interested in fostering: *
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| 18. |
List any general questions you would like to ask about this particular pet:
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| 19. |
Are you willing to allow a representative from Georgia Humane to visit your home by appointment?: *
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| 20. |
Please indicate your type of dwelling: *
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| 21. |
Rent or own: *
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| 22. |
If you rent, do you have the landlord’s permission to own a pet?: *
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| 23. |
Apartment Complex Name:
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| 24. |
landlord’s phone number:
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| 25. |
How many times have you moved in the past 5 years?: *
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| 26. |
Do you or anyone in your household currently have any serious health problems? If yes, describe: *
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| 27. |
What procedures will you use for house training?: *
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| 28. |
If other, please describe:
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| 29. |
What will you do if your pet has an accident in the house?: *
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| 30. |
Who will be responsible for the daily care and training of you new pet?: *
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| 31. |
Do you have a fully fenced yard with no fence gaps? If yes, how high and what kind?: *
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| 32. |
If no fence, how do you plan to keep the pet on your property?: *
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| 33. |
If other, what?:
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| 34. |
Number of adults in household: *
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| 35. |
Relationship:
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| 36. |
Do any children live in the house? If Yes, what are their ages?: *
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| 37. |
Any current pets in your household, now?: *
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| 38. |
If yes, what kind and how old?:
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| 39. |
Do any of your current or past pets live primarily outdoors? If yes, please describe pet: *
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| 40. |
Are all current pets spayed and/or neutered?: *
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| 41. |
Do you know what heartworm disease is and how to prevent it?: *
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| 42. |
Is your current pet on heartworm prevention medication?: *
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| 43. |
Your veterinarian's name:
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| 44. |
Your veterinarian's phone number:
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| 45. |
How many pets have you fostered in the past?: *
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| 46. |
How many hours will the pet be home alone on a typical day?: *
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| 47. |
Where does your current pet stay when home alone during the day?: *
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| 48. |
Where will your foster pet stay when home alone during the day?: *
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| 49. |
Where do current pets sleep at night?:
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| 50. |
Where will your foster pet sleep at night?: *
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| 51. |
What percentage of time will the pet spend inside the house?: *
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| 52. |
Have you ever had a serious behavior problem with a previous pet? If so, please describe: *
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| 53. |
Do you have a doggie door?: *
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| 54. |
Are you willing to keep a collar and ID tag on all pets including your new pet at all times?: *
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| 55. |
Under what circumstances do you think it is OK to leave a dog outside alone and unsupervised?: *
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| 56. |
What circumstances justify giving up a pet?: *
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| 57. |
Have you ever given up a pet or had a pet because it didn’t work out? If yes, please explain the circumstances and what happened to the pet: *
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| 58. |
Have you ever fostered a pet from a humane society? If yes, please explain: *
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| 59. |
If you date or marry someone who does not like or want your pet, what would you do?: *
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| 60. |
Has a pet died on your premises in the last 6 months of Distemper, Parvovirus, or unknown causes? If yes, please explain: *
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| 61. |
Please list names, addresses and phone numbers of 2 personal references:
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| 62. |
I hereby authorize The Georgia Humane Society to check the references provided in this application. I believe the information provided to be true and correct and understand that the application will be denied or GHS may request that the pet be returned if it is determined that the information contained in this application is false or misleading. I also understand that Georgia Humane Society will choose the adopter of any pet based on the best interest of the animal. A home check may be required before the pet can be released to his/her new family. Spay or Neuter will be completed prior to adoption. All family members must be available for interview during the application process. Applicant Signature - Type your full name in order to sign this application: *
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| 63. |
Co-Applicant Signature - Type your full name in order to sign this application:
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