South Plains SPCA Foster Application 2012

Note: Please fill out application completely. Any unchecked or blank spaces will mean your
application will not be given full consideration. Thank you.

Name:____________________________________________
Phone Number:________________________________
Address:______________________________ City:____________________ State:_______ Zip:_____________
Email:_____________________________________________
DL Number:_________________________ State:________
Alternate Contact: ________________________________________
Alternate Contact Phone Number: _______________________________

Number of People in the Home:________ Age of Children:__________________________________________

Do you live in a: HOUSE APARTMENT DUPLEX OTHER

Do you: OWN or RENT?

Name of Landlord (Apartment): ______________________________________________

Phone Number: _______________________
Do you have a fenced yard? Yes No Type: _______________________ How tall? ___________________
What is the size of your yard? ______________________________________________
Do you have any pets? Yes No
Breed:____________________ Age:______ M F Current on Vaccinations? Y N Spayed/Neutered? Y N
Breed:____________________ Age:______ M F Current on Vaccinations? Y N Spayed/Neutered? Y N
Breed:____________________ Age:______ M F Current on Vaccinations? Y N Spayed/Neutered? Y N
Breed:____________________ Age:______ M F Current on Vaccinations? Y N Spayed/Neutered? Y N
What type of animal would you prefer to foster?
Dogs
Small

Puppies
Medium

Cats
Large

Form 1 Version March 30, 2012

Kittens

Male

Extra Large

Female
Special Needs
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South Plains SPCA Foster Application 2012

Do you have an area where the animal can be quarantined if needed? Yes No
Are you able to transport your foster to vet appointments and adoption events? Yes No
How many animals are you willing to foster at a time? ____________
Veterinarian Name:____________________________________________________
Phone #:_______________________________________

Do you volunteer/foster for another rescue organization: Yes No

If yes which one: ________________________________________________________________

Please provide 3 references:

1. Name: _____________________________________
Phone Number: _______________________________
Email: _______________________________________
2. Name: _____________________________________
Phone Number: _______________________________
Email: _______________________________________
3. Name: _____________________________________
Phone Number: _______________________________
Email: _______________________________________

Form 1 Version March 30, 2012

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South Plains SPCA Foster Application 2012

Terms and Conditions

South Plains SPCA will provide medical care for the animal being placed in your home. Foster care
providers will provide proper food and shelter in a loving, safe environment for the foster pet. All cats
must be kept indoors. Foster care providers may not use the pet for medical research, fighting,
personal protection training or any use other than companion animal. The responsibility of the foster
pet belongs jointly to South Plains SPCA and the foster care provider. If for some valid reason the
foster pet does not work to the advantage of the foster care provider and the pet, South Plains SPCA
must be contacted for the return of the pet. A foster care provider will not place them in a new home.
South Plains SPCA is not liable for damages to property, injuries to personal pets or personal injuries
inflicted by the foster animal.

I _______ (initials) understand that SPSPCA, without notice or hearing, may terminate my
volunteer services as a volunteer at any time, with or without reason.

I _______ (initials) do agree to a criminal background check.

I have read and understood the terms and conditions and verify that all above information is
true and accurate.

Signature:____________________________________________

Date:_________________________

To be verified by SPSPCA:
State Drivers License: ________
Drivers License Number: ___________________________________

SPSPCA Representative Signature: ________________________________________________

Form 1 Version March 30, 2012

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