Name* First Last Cell PhoneHome PhoneWork PhoneAddress* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* What kind of animal(s) are you interested in fostering?*Name(s) and ages of other adult member(s) of householdWho will be responsible for this animal?*What kind of home do you live in?*HouseApartmentMobile HomeDuplexDo you:*OwnRentLive with parents/relative/friendIf renting, does your landlord/rental agency allow pets?YesNoI don't knowLandlord's name First Last Landlord's phoneHow long have you lived at your present address?*If you have children at home, what are their names and ages?Are they used to animals?YesNoIs anyone living in your household allergic to animals?*YesNoDo all adult members of the household know that you plan to foster a pet?*YesNoDescribe your household activity level/noise level.*What is the typical family schedule like?*Please explain why you want to foster a pet?*Do you have other pets at home?*YesNoAre the other dogs and cats in the home spayed or neutered?YesNoIf no whyPlease list for all pets that will come into contact with this foster pet: Breed, age, sex, spay/neutered, time owned, personality with other dogs:Are all your pets current on their vaccinations?YesNoI don't knowWhat is the name and address of your veterinarian/clinic?How many hours per day will this pet be alone? (without human companionship)*Where will this animal be during the day?*Where will this animal sleep?*When this animal is outside, will it be in a fenced yard, on a leash, allowed to run loose, on a trolley, Chained? (Please indicate all that apply.)*Do you have a fenced yard?*YesNoIf you have a fenced yard, how high is it (how many feet tall) and what is it made of (chain link, stockade, etc.)?Are you aware of your local animal control regulations?*YesNoDo you know basic dog obedience techniques?*YesNoDo you know how to crate train a dog?*YesNoWould you like to sign up for our email newsletter? We'll never share, sell or use your email address for anything other than occassional emails about PC Humane activities. You can unsubscribe at any time.*Yes, sign me up!No thanks.Your Signature*Type your nameToday's Date* Please note that we will respond to this application within 48-72 hours Mon-Fri. After you hit the "submit" button, you should receive confirmation of your submission. If you do not receive confirmation or a response from us, we likely did not receive your application. Please email us at email@example.com if you do not receive a response from us. If you have questions, please call (580) 767-8877. Ponca City Humane Society reserves the right to refuse any applicant. Thank you!