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Reptile Foster Home Application
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Reptile Foster Home Application
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APPLICANT INFORMATION
APPLICANTS MUST BE 18 OR OLDER.
Foster Home Applicant
*
First
Last
Address
*
Address Line 1
City
State / Province / Region
Postal Code
Mobile Phone
*
Home Phone
Email
*
Employment Status
*
Employed
Student
Retired
Other
Please provide details
*
FAMILY INFORMATION
What type of home do you reside in?
*
House
Condo
Duplex
Apartment
Do you own or rent your home?
*
Own
Rent
Please provide landlord’s name:
*
Landlord’s phone number:
*
How long have you been at your current address?
*
Do you have children at home?
*
Yes
No
What are the ages of your children?
*
Are the children accustomed to and educated about reptiles?
*
Yes
No
Why do you (and your family) want to foster a reptile?
*
Have you ever owned a reptile before?
*
Yes
No
If so, how long did you have it and if you no longer have it, what happened to it?
*
REFERENCES
Please provide the name and phone number of two (NON-FAMILY) references that are aware of you and/or your families’ interaction with pets (ie: vet, neighbour or friends):
Reference 1
*
First
Last
Phone
*
Reference 2
*
First
Last
Phone
*
REGARDING THE REPTILE
What types of reptiles are you willing to foster?
*
Lizard
Snake
Turtle/Tortoise
Amphibian
Other
If other, please list:
*
Are there any types of reptiles you DO NOT want to foster? If so, please list them here:
*
Do you have a size/weight preference of the reptiles you are willing to foster?
*
Yes
No
If yes, please provide those details:
*
What traits are most important to you in the reptile you are willing to foster:
*
Good with Children
Friendly
Low Energy Level
Needs Special Medical Care (i.e. disabled, etc)
Willing to work with reptiles that need extra attention
Other
If other, please list:
*
How much time are you able to spend with this reptile per day?
*
4 hours or less
4-8 hours
8 hours or more
Do you already have the proper shelter, lighting, and food?
*
Yes
No
Are you able to transport the reptile you are fostering to and from the vet, if necessary?
*
Yes
No
Would you be willing to contact Persian Dreams & Canine Themes Rescue Society for advice and suggestions to help you and your reptile to be successful if there are behaviour concerns?
*
I would be willing to contact PDCT for advice.
ADDITIONAL INFORMATION
Do you have any additional information you would like to share with us?
*
Yes
No
If there is anything additional you would like to add, please do so here:
*
FOSTER HOME TERMS
Please read and agree to the following Foster Home terms:
I acknowledge that all of the information contained in this form is true and correct to the best of my knowledge.
*
I Agree
I hereby state that Persian Dreams & Canine Themes Rescue Society is not liable for any destruction of property or aggressive behaviour from a foster reptile. I understand that PDCT has evaluated, to the best of their ability, to place with me a compatible reptile. I understand also, that I must be in control of my own animal(s)/reptile(s) at all times and in control of the foster reptile(s).
*
I Agree
I hereby state in this agreement, that if in fact; the foster reptile in my home is not working out and must be removed, to allow adequate time for re-placement (up to three weeks).
*
I Agree
I hereby state that Persian Dreams & Canine Themes Rescue Society will provide the foster reptile with the basic necessities it will need. This includes food and medical costs.
*
I Agree
Any contributions from the foster home such as food, paying vet bills, etc. is very welcomed and appreciated; however, it is not a requirement.
FOSTER HOME TERMS ACCEPTANCE
Applicant Signature
*
Date
*
The information provided in this document is confidential and will only be shared with the adoption applicant’s consent.
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