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* Age*Please enter a number from 18 to 99.Do you work outside of home?* Yes No How many hours are you away from 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?*YesNoDo you have interest in fostering any of the following? Check all that apply.* Kittens that need to be bottle fed Cats/kittens with special diets Cats/kittens that need socializationg Kittens that eat wet food but not hard food Cats/kittens with special needs Senior/Geriatric cats 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?*YesNoAre you able to make any vet appointments that your foster may need?*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?*YesNoDo you have any experience vetting animals? (Giving fluids, injections, medications)*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.