Title
DR
MISS
MR
MRS
MS
First Name *
Last Name *
Email Address *
Home Address *
City *
State *
Zipcode/Postcode *
Country *
-- Select Country --
AFGHANISTAN
ALAND ISLANDS
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CâTE D'IVOIRE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, THE DEMOCRATIC REPUBLIC OF THE
COOK ISLANDS
COSTA RICA
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HOLY SEE (VATICAN CITY STATE)
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN, ISLAMIC REPUBLIC OF
IRAQ
IRELAND
ISRAEL
ITALY
JAMAICA
JAPAN
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF
KOREA, REPUBLIC OF
KUWAIT
KYRGYZSTAN
LAO PEOPLE'S DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FEDERATED STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT HELENA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA AND MONTENEGRO
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SPAIN
SRI LANKA
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
TANZANIA, UNITED REPUBLIC OF
THAILAND
TIMOR-LESTE
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES
UNITED STATES MINOR OUTLYING ISLANDS
URUGUAY
UZBEKISTAN
VANUATU
VENEZUELA
VIETNAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
ZAMBIA
ZIMBABWE
Home Phone Number *
Work Phone Number *
Cell Phone Number *
Enter Word Verification in box below *
Have you ever fostered an animal before? *
If YES, please provide the type of foster (dog, cat, etc.) and the organization for which you fostered:
What type(s) of animals are you willing to foster? *
What age pet would you consider fostering? *
Do you prefer a male or female pet? *
-- Please select --
Male
Female
Do you have a size preference? *
-- Please select --
Yes
No
If YES, what is your preference?
Select the traits that are most important to you in a foster animal: (Please check all that apply) *
If OTHER, please explain:
Would you consider fostering more than one pet? *
-- Please select --
Yes
No
Are there any particular pets you would not want to foster? *
-- Please select --
Yes
No
If YES, please specify:
Have you had other pets within the past ten years? *
-- Please select --
Yes
No
Please describe your previous pets in detail: (Name, Age, Gender, Altered, Declawed) *
Where are they now? *
If you currently have pets in your home, will they accept another animal? *
-- Please select --
Yes
No
Are all of your pets current on their vaccines? *
-- Please select --
Yes
No
Why are you interested in fostering an animal? *
What are your current living arrangements? *
-- Please select --
House
Apartment
Condo
Trailer
Do you rent or own? *
-- Please select --
Rent
Own
If you rent, please provide contact information for you landlord:
Do you have a yard? *
-- Please select --
Yes
No
If YES, is your yard chemically treated?
-- Please select --
Yes
No
How big is your yard?
Is the yard completely fenced in?
-- Please select --
Yes
No
What type of fencing do you have?
Do you have a pulley cable? *
-- Please select --
Yes
No
Approximate length of pulley cable?
Do you have a kennel run? *
-- Please select --
Yes
No
Approximate dimensions of kennel run:
If you do NOT have a fenced yard, cable or kennel run, how will excersice/toilet be handled?
Please list the names and ages of all ADULTS in the house: *
Please list the names and ages of all CHILDREN in the house: *
Does anyone in your house have allergies? *
-- Please select --
Yes
No
If YES, please specify details:
Does anyone in your house have asthma? *
-- Please select --
Yes
No
In anyone home during the day? *
-- Please select --
Yes
No
If YES, who?
In NO, how many hours per day will the animal be left alone?
Where will the animal be kept during the day? *
Where will the animal be kept at night? *
Where will the animal sleep? *
Will you crate the dog? *
-- Please select --
Yes
No
If NO please explain:
Have you participated in obedience training with a dog? *
-- Please select --
Yes
No
Do you plan to train your foster dog? *
-- Please select --
Yes
No
What will you do if your foster pet is destructive? *
What is your definition of disciplining an animal? (Please give examples) *
Have you thought about how your family will handle difficult situations that may arise with a new foster animal? *
-- Please select --
Yes
No
How did you hear about the Simon Foundation? *
