Complete the form below to apply for foster parent status. Pet Foster Application Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone (Best Contact Number)*Email* PreferencesSelect all that applyDogsPuppiesCatsKittensNursing mom/litter - puppiesNursing mom/litter - kittensRabbitsOtherSpecify Other - Preference*Special CasesBottle FeedHealth IssuesSeniorsNeeds SocializationOtherSelect all that applySpecify Other - Special Case*How many animals can you care for at once?*Tell us briefly your history with pets?*Are you able to bathe or groom your foster?YesNoHave you ever fostered pets before?YesNoPlease describe briefly your foster experienceHow did you learn about the FHS Foster Program?Would you allow an FHS Representative to visit your home?YesNoIf you had too, can you keep fosters away from your other pets?YesNoAre you able to keep appointments for vaccinations?FHS provides medical treatments and this is important for young pets still receiving vaccinations/boosters.YesNoAre you able to provide for the animals in your care?FHS provides initial supplies for your foster, but if you can help with food, beds, kennels, bowls - it greatly helps us due to lack of funding.YesNoAre you able to deal with the death of an animal if this happens?YesNoDo you currently have pets in your home?YesNoAre your pets current on their vaccinations?YesNoNot SureWho is your current veterinarian?Please list the pets that currently reside in your home.Name / TypeAge / SexSpayed/Neutered? I understand that foster animals remain the property of the Flagler Humane Society, and they retain all rights regarding animals in foster care. All information provided is correct.Do you agree with the statement above?* Yes By checking this box, you are acknowledging your agreement to the statement above.NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.