аЯрЁБс>ўџ ;=ўџџџ:џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС'` јП)bjbjLULU .&.?.?)џџџџџџЄ:::::::Nvvvv ‚$N|ьВ:ьььььььћ§§§§§§$hhаX!:cььcc!::ьь6УУУc :ь:ьћУcћУУ::УьІ Uўа-Яvm6УћL0|У(Ѓ(У(:У8ьZF@У†4КЉььь!!Й ььь|ccccNNNФ dNNNNNN::::::џџџџ GATEWAY 4 PAWS  HYPERLINK "http://www.gateway4paws.org" www.gateway4paws.org  HYPERLINK "mailto:gateway4paws@gmail.com" gateway4paws@gmail.com  HYPERLINK "http://www.facebook.com/gateway4paws" \t "_blank" www.facebook.com/gateway4paws FOSTER HOME APPLICATION PO Box 4533 Fairview Heights, IL 62208 Name___________________________________________________ Address__________________________________________________ Email____________________________________________________ Phone (H)______________________(C)___________________________ (Work)__________________________ County________________ Occupation_____________________________ Work Full time_______ Part time______ Do not work_________ Name and age of all other individuals in the home___________________________________________________________________________________________________________________________________________________________________________________________________________________ Do you own or rent__________________ Landlord name and phone # __________________________________________________________________ Home_____ apartment_____ condo_________ mobile home____________ Do you have a fenced yard________ Type of fence____________Height________ If you do not have a fence, how will you take the pet out?________________________ Is anyone home during the day?________________________________ If not, how long will the foster dog be left alone?_______________________ Where will the dog be kept when alone?________________________________ Where will the dog spend days?_____________________________________ Where will the dog sleep?_________________________________________ Do you have other animals in the home?________________________ Type/Age/Breed/Gender of all pets in the home: __________________________________________________________________________________________________________________________________________________________________________________________________________________ Are they spayed/neutered?__________________________________________ Are they up to date on all vaccinations?_______________________________ Bordatella?_____________________________________________________ Are they currently on heartworm preventative?_____________Flea/tick_______ Do your pets live Inside_______Outside_______________ Please provide name and contact information for your veterinarian_____________________________________________________________________________________________________________________________________ Do you have experience fostering?__________________________ If yes, with which organization and when___________________________________________________________________ Why are you interested in fostering_______________________________________________________________ Do you have experience with dog training______________________ Aside from fostering, are there other ways in which you would like to help our rescue?______________________________________________________________ Review applications?_______________Transport?______________________ Home visits?_______________________ What type of fostering are you interested in? General_______________ Temporary/emergency___________________ Hospice/long term_______________________ Isolation fostering______________ What type of dog are you willing to foster? Male________ Female_____________ Puppy______ Young______ Adult________ Senior_________ Are there any breeds you would not want to foster?__________________ How many dogs would you be willing to foster?_______________________ References: Name______________________Phone______________________relationship________ Name______________________Phone______________________relationship________ ABOUT US Gateway 4 Paws is a non-profit, all volunteer, 501c3 pending organization that rescues small breed dogs from high kill shelters both locally and nationwide. We provide all necessary veterinary care, including spay/neuter, vaccinations, microchip, and care for any illness. ACKNOWLEDGEMENT I acknowledge that the information contained in this application is true and correct to the best of my knowledge. I also understand that Gateway 4 Paws will not be responsible for any damage caused by the fostered animal(s). Signature of applicant____________________________ Date_______________________  :;<PQTU€‚˜™œлмљњћ   " < = > ? 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