Department of Animal Services
Foster Home Program Application

Name:
Address:	Apt #:
City:	State: Zip Code:
Drivers License #:	State:
Employer's Company Name:
Home Phone #:	Work Phone #:
Your E-mail :

1.) Do you live in a ...	Condo/Townhouse Apartment Duplex Mobile Home House
2.) Do you ...	Rent/Lease Own ... your residence?
3.) How many adults reside in the household?   How many children reside in the household? 4.) Have you ever had to turn an animal over to an animal shelter? Yes No 5.) Do you have any dogs/puppies and/or cats/kittens at home now? Yes No How many dogs? Are they all licensed? Yes No How many cats? Are they all licensed? Yes No
6.) Will there be anyone at home during the day? Yes No
If Yes, who?
7.) Have you had pets in the last 5 years? Yes No
8.) Which Animal Hospital/Clinic do you (or did you) use?
9.) Approximate date and reason of last vet visit.
10.) Has anyone in your household ever had allergies to animals? Yes No
11.) Has anyone in your household ever nursed orphaned puppies or kittens? Yes No
12.) Are you aware that time and expenses are incurred when you foster animals? Yes No
13.) Would you like to foster a.... Dog   How many?   Cat   How many?   Orphaned puppies   How many?   Orphaned kittens   How many?

We want to THANK YOU for your interest in providing a foster home for an animal.
For more information on our Fostering Program or on Animal Services please contact us at
(813)744-5660 or visit our website at: www.hillsboroughcounty.org/animalservices/