Company Date * First Name * Age of Foster Applicant * 18+ Under 18 Last Name * Select Location * Antigonish Cape Breton Dartmouth/Provincial Animal Shelter Hants Kings La Baie Lunenburg Pictou Queens Yarmouth Colchester Street Address * City * Postal Code * Address Line 2 Province * Nunavut Quebec Northwest Territories Ontario British Columbia Alberta Saskatchewan Manitoba Newfoundland and Labrador New Brunswick Nova Scotia Prince Edward Island Home Phone * Cell Phone Work Phone Email * Describe your home * House Townhouse Apartment Mobile/Mini Home Do you: * Rent* Own Live with parents *If renting please provide the name and phone number of your landlord How long have you lived at your current address? If less then one year, please provide your previous address Do you have a fenced in yard? Yes No* Applies to dog fostering only. *If no, how will the foster dog go outside? Applies to dog fostering only. Do you have access to a vehicle? * Yes No You will need reliable access to a vehicle to transport your fosters to the shelter for medical care and to pick up supplies. Number of adults in the house * Over 18 years of age Number of children in the house * Under 18 years of age If there are children in the home please list their ages. Do any members of the household have asthma or allergies? If yes, please list Are you: * Working Student Retired Other Describe the noise/activity level of the home * Quiet Moderate Busy Very busy Are you willing to have a Nova Scotia SPCA representative visit you for a home check? * Yes No If required What animals have you owned in the past five (5) years? Please include the following: Name, Breed/Type, Sex, Spayed/Neutered, Age, kept Indoors/Outdoors, and if they are still with you or deceased. Are your family pet(s) spayed/neutered? * Yes No Some of them List the veterinary clinic(s) that care(d) for your pets Please include name, address and phone number Foster Experience: * I have litter trained a cat. I have house trained a puppy. I have house trained a dog. I have crate-trained a dog. I have obedience-trained a dog. I would be willing to take a foster animal to obedience classes. (Provided by the SPCA) I have been involved with the birth of an animal I have experience in caring for the sick, injured, or abused animals. Please check all that apply Please list any additional skills or training that may be helpful in fostering an animal in your home. Home many hours a day will your foster animal be left alone? * Please enter a number from 0 to 24. Where would you keep a foster animal when you are at home? * Where would you keep a foster animal when you are NOT home? * Category of animals interested in fostering: * OWNED pets through the Domestic Violence Assistance Program Pregnant/nursing cats Orphan kittens Injured cats Healthy cats Pregnant/nursing dogs Orphan puppies Injured dogs Healthy dogs Other types of animals Please check all that apply Where would the foster animal sleep at night? Reference #1 First Name * Last Name * Contact Number * What is your relationship to reference #1? * Reference #2 First Name * Last Name * What is your relationship to reference #2? * Contact Number * Reference #3 First Name * Last Name * What is your relationship to reference #3? * Contact Number * Consent - Yes - I certify that the above information is true and know that false information may result in this application being declined. I also acknowledge that The Nova Scotia SPCA reserves the right to decline any application. Yes - I certify that the above information is true and know that false information may result in this application being declined. I also acknowledge that The Nova Scotia SPCA reserves the right to decline any application. *
