Cat Foster Application

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Default Status
First Name*
Last Name*
Age Range*
Select Age Range
eMail Address*
eMail Address Confirm eMail Address
Street Address*
Suite | Apt or Unit Number
City*
State/Province*
Select State
ZIP*
Country*
United States
Home Phone Number
Work Phone Number
Cell Phone Number*
Preferred Method of Contact
Select Method
Employment & Schooling
- Are You Employed?*
  - Yes
  - No
  - Retired
- Full or Part Time?*
- Name of Employer*
- Are You In School?*
  - Yes
  - No
- Full or Part Time?*
- How Did You Hear About Us?*
  Select Source
- What Is Your Friend's Name?*
- Which Shelter?*
- Which Rescue?*
- Please Describe*

First Name	Last Name	Age Range	Gender	Actions
There are no Adults.

Name	Age	Gender	Actions
There are no Children.

Cat's Name	Breed	Age Range	Gender	Actions
There are no Cats.

Pet's Name	Animal Type	Sleeping Quarters	Actions
There are no Pets.

Would You Consider:
Select all that apply.
Two Cats*
A Pregnant Cat*
Fostering Bottle Babies*
A Cat That Can Be An Only Pet?*
A Cat That Is Afraid Of Small Children*
A Cat That Needs Medications?*
- A Cat That Has a Serious Health Condition?*
- Please Select All Health Condition(s) You Would Accept:*
- A Cat That Has Special Needs?
- Please Select All Special Needs(s) You Would Accept:*
  Select All That Apply
A Cat That is Litterbox Trained?*
Select Gender*
Select Age Range*
Select All That Apply
Select Personality*
Select All That Apply
Do You Have A Preferred Cat?
List Other Cats You Are Interested In
When Will You Be Ready To Foster?*
Is There Anything Else You Would Like to Let Us Know?
I am interested in receiving pet related services and products
- Yes
- No
Authorization
Authorization:*
All cats placed through the Des Moines County Humane Society will have health checks, personality and temperament evaluations, and will be spayed or neutered prior to placement unless a medical condition exists, diagnosed by a veterinarian, that would prevent this surgery. I understand that this is a preliminary application and that there may be no cat available in rescue at this time. I understand that if a cat should become available, that I will be required to provide further information including, but not limited to, personal and veterinary references. I further understand that all information on my Preliminary Rescue Cat Foster Application will be kept confidential; that my application will be kept on file until I notify the Des Moines County Humane Society that I am no longer interested in a rescue; and that I will not be contacted unless an appropriate cat becomes available. I understand and agree *
- I agree
Name
This field is for validation purposes and should be left unchanged.

Foster: Cat

Employment & Schooling

Family & History

Feeding & Exercise

Sleep & Alone Time

Behavior & Training

What Behaviors Can You Tolerate (AND WORK ON)?

Personal Reference

Veterinarian Information

Groomer Information

Foster Care

Would You Consider:

Authorization

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