Personal Information 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 Home Phone*Cell Phone*Email* Are you over 18 years old?*YesNoDo you*Work full-timeWork part-timeDon't workHow many hours are you home during the day?*Personal Veterinarian's Name* First Last Personal Veterinarian's Phone Number*Were You Referred To Us? How did you hear about fostering?May we thank someone for referencing you?*If applicable First Last Living Arrangements Do you:*OwnRentLive with ParentsLandlord Name*If applicable First Last Landlord Phone Number*If applicable Number of Adults in Household*Number of Children in Household*Age's of Children in Household*Please list all other pets in household and their ages. (Please also specify if the pet is a dog, cat, etc. and if the pet is kept indoors or outdoors).*Are all of your pets altered?*YesNoFostering Information Have you fostered before?*YesNoWhich are you interested in fostering?*DogsCatsNo PreferenceWhat type of dog would you feel most comfortable fostering? Please select all that apply.* Small Adult (< 25 lbs.) Medium Adult (25-45 lbs.) Large Adult (50-110 lbs.) Puppies (Under 6 months) How long are you willing to foster?*2 weeks or less3 weeks or lessUntil adoptedDo all household members agree to you fostering animals?*YesNoDo you understand the potential health risks to your own pets or family associated with fostering?*YesNoDo you understand the foster animal you are bringing into your home may have behavior issues that are not yet known to us?*YesNoDescribe the areas where the foster pet will be contained when unsupervised*Describe the area where the foster will sleep*Describe your outdoor potty, play area and fencing for the foster*Are you willing to administer medications if needed?*YesNoAre you willing to transport Pet to/from AAA and adoption events?*YesNoAre you willing to promote AAA's efforts to reduce homeless pets by promoting spay/neuter, microchipping, leash/crate/behavior training, indoor homes, preventive health including Heartworm/Flea/Tick Prevention, vaccinations and diet?*YesNoWould you agree to having your property checked prior to taking animals into your home?*YesNoPlease describe your experience with animals: litter box/house training, fearful, feral, bottle feeding, socialization, crate training, leash training, etc:*What else would you like us to know about you?Validation By typing your name here, you agree to the following: By submission of this application, I assert that all statements and answers given here are the truth. I give AAA representatives permission to verify that the information is true and correct.* First Last Initials* This iframe contains the logic required to handle Ajax powered Gravity Forms.