[Queen Anne’s County] QACAS Foster Application

Section 1 of 3 in this document

QACAS Foster Application

First Name

Last Name

Physical Address

Address or Location

Does Mailing Address differ from Physical Address?

Phone Number

Birthdate (MM-DD-YYYY)

Age

Emergency Contact

Emergency Contact Relationship

Emergency Contact Phone Number

Section 2 of 3 in this document

Do you currently have any household animals?

Name of household animal

Type of household animal

Age of household animal

Male or Female

Are they spayed or neutered?

Please list vaccines

Do you need to add another household animal?

Name of household animal

Type of household animal

Age of household animal

Male or Female

Are they spayed or neutered?

Please list vaccines

Do you need to add a third household animal?

Name of household animal

Type of household animal

Age of household animal

Male or Female

Are they spayed or neutered?

Please list vaccines

Please let us know the name/type of animal you're interested in fostering.

How many hours will this animal be left alone at a time?

Where will they stay when they're left alone?

Please select your type of residence

Do you rent or own your property?

Are there any breed/animal restrictions?

Have you fostered or worked with any animal organization?

Please list the animal orginization.

Are there any animals you are uncomfortable/unwilling to handle?

Please list what kind

Are there any topics you wish to discuss with QACAS staff?

Please list your topics

Please sign here

First Name

Last Name

Choose how to sign

Draw Type

I hereby certify that I am at least 18 years of age and that everything on this application is true. QACAS can deny my application if it deems not in the best interest of the animal. QACAS reserves the right to request additional materials prior to approving this application including but not limited to vet reference, verification of ownership of residence, proof of income, etc. We may also contact other shelter/jurisdictions regarding history of pet ownership or complaints.