Cart
0
Home
Adoptable Animals
Events
Birthday Party Info
Donate
Become A Sponsor
Cat Stream!
Store
Adoption Forms
Foster Forms
Volunteer Info
Sponsors
Employment
Helpful Links
Lost & Stray Animals
Boarding
Training
FAQ
Contact
Cart
0
Home
Adoptable Animals
Events
Birthday Party Info
Donate
Become A Sponsor
Cat Stream!
Store
The Babinski Foundation Animal Shelter
Adoption Forms
Foster Forms
Volunteer Info
Sponsors
Employment
Helpful Links
Lost & Stray Animals
Boarding
Training
FAQ
Contact
Foster Application
You must be 18 years of age or older to foster an animal.
Applicant Information
Name:
*
First Name
Last Name
Date of Birth
*
MM
DD
YYYY
Phone:
*
(###)
###
####
Employer:
Occupation:
*
Work hours per week:
Email Address:
*
Address:
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Do you have a fenced in yard?
*
Yes
No
Do you live near a pool of water or have a pool on site?
*
Yes
No
Do you agree to let a member of the Babinski Foundation staff perform a home check, not to judge your home but to see where the animal will be staying?
*
Yes
No
Do you rent or own your home?
*
If you rent, we must have a signed letter on letterhead from you landlord informing us that it is acceptable to foster an animal at this time.
Rent
Own
Landlord's Name:
First Name
Last Name
Landlord's Phone Number:
(###)
###
####
Do you smoke in your home?
*
Yes
No
Emergency Contact Information
This section is for you to put down all of your medical emergency contact information, if you wish to do so. This information will not be used for any other purpose.
Insurance Company:
Policy Number:
Doctor's Name:
First Name
Last Name
Doctor's Phone Number:
(###)
###
####
Emergency Contact:
First Name
Last Name
Emergency Contact's Number:
(###)
###
####
References
Please list two non-related references .
First Reference:
*
First Name
Last Name
First Reference's Phone Number:
*
(###)
###
####
Second Reference:
*
First Name
Last Name
Second Reference's Phone Number:
*
(###)
###
####
Additional Information
What species of animals are you interested in fostering?
*
Check all that apply
Cats
Pregnant Cats
Dogs
Pregnant Dogs
How many animals are you able to foster, with appropriate care?
*
How long are you able to foster an animal for?
*
Name(s) of animal(s) interested in fostering:
Do you have the knowledge and skills to give vaccinations?
*
Yes
No
Do you have the knowledge and skills to bottle feed nursing animals?
*
Yes
No
Have you ever whelped litters?
*
Yes
No
Please list the name, age, and relationship of anyone else living in your household:
Please list any pet's you currently have in your household:
Include their name, species, and age.
Do you have any physical or medical limitations which may limit your participation as a volunteer?
Have you ever consulted with a professional person for psychological disorders concerning animals?
Do you have your own transportation?
Yes
No
Do you have an insured truck or van?
Yes
No
Why are you interested in fostering an animal at this time?
Will the animal be primarily inside or outside?
*
Inside
Outside
Will the animal sleep inside or outside?
*
Inside
Outside
How long will the animal be alone at your home?
*
Will you be able to tolerate potty accidents in your home?
*
Yes
No
What solutions would you use if accidents continue after a few days?
Will your personal animals be in contact with the fostered animals?
*
Yes
No
Are there any pregnant animals at your home currently?
*
Yes
No
Any juvenile animals at your home?
*
Animals under the age of 5 weeks.
Yes
No
If you have any personal animals at your home, are they currently up to date on recommended vaccinations?
(Dogs) Distemper, Parvovirus, Adenovirus 1, Rabies (Cats) Herpes, Calici, Panleukopenia, Feline Leukemia, Rabies
Yes
No
What food do you feed your pets?
How often do you feed your pets?
Where do you feed your pets?
Do you feed them separate or together?
What methods of training do you use on your personal pets?
Do you currently have a veterinarian?
Yes
No
Veterinarian's Name:
First Name
Last Name
Veterinarian's Phone Number:
(###)
###
####
What brand or method of flea and tick control do you use, and how often do you do it?
What brand of heartworm control do you use, and how often?
Foster limitations?
List any additional information or concerns:
Disclaimer
I certify that my answers are true and complete to the best of my knowledge. I give permission to the Babinski Foundation to contact my veterinarian, landlord, or any other persons to verify my disclosed information within this survey. I certify that I will be the primary caregiver of any fostered animals. If this application leads to me becoming a volunteer, I understand that false or misleading information in my application may result in my release from the Babinski Foundation. I understand that the Babinski Foundation requires the assistance of volunteers in conducting its various programs. It is my desire to further the work of the Foundation by performing services as a volunteer. I agree to perform these services without compensation, and in performing my services, I acknowledge that I am not acting as an employee of the Foundation. I will not hold the Foundation liable for any personal or property damage I may incur while performing volunteer services. I agree to conform to the Foundation’s policies and procedures while volunteering. I agree to hold all information shared with me while volunteering at the Babinski Foundation in strict confidence.
Volunteer Insurance Waiver
I understand that the Babinski Foundation requires the assistance of volunteers in conducting its various programs. It is my desire to further the work of the Foundation by performing services as a volunteer. I undertake to perform these services without compensation, and in performing my services, I acknowledge that I am not acting as an employee of the Foundation. I will not hold the Foundation liable for any personal or property damage I may incur while performing volunteer services. I agree to conform to the Foundation’s policies and procedures while volunteering. I agree to hold all information shared with me while volunteering at the Babinski Foundation in strict confidence.
Confidentiality Agreement
This confidentiality agreement is required for the protection of the Babinski Foundation and in recognition that employees/volunteers/board members of the Babinski foundation may either acquire or observe documents, or overhear conversations, or information that is private and confidential in nature. Accordingly, the undersigned employee/volunteer/board member agrees that if he or she comes into possession of either written or oral information of any kind about the Babinski Foundation about its employees/volunteers/board members, or clients as the result of employment/volunteer/board work with the Babinski Foundation, the undersigned agrees to keep all such information confidential and not disclose or publish this information to any person unless expressly permitted in writing by the Babinski Foundation executive director. It is acknowledged that this agreement is not only for the protection of the Babinski Foundation and its clients regarding their confidential information but the agreement is also a reminder to the undersigned that inappropriate disclosure of such information by the undersigned could expose the undersigned to liability or claims if the disclosure of such information cause either monetary damage or other irreparable harm to the Babinski Foundation or its clients.
Signature
*
By entering my full name here, I fully agree to the above written disclaimer, Volunteer Insurance Waiver, and Confidentiality Agreement
Thank you!
