| APPLICATION & AGREEMENT FOR FOSTER CARE PROVIDER | #1 |
| Date | Saturday, January 26, 2013 |
| Name | Don Mertes |
| Home Number | (602) 795-2260 |
| Cell Number | (602) 919-8471 |
| Work Number | (602) 795-2260 |
| donmertes1@cox.net | |
| Address |
1509 East Granada Road Phoenix, AZ 85006 United States |
| Is this address: | Permanent |
| If seasonal, when are you in the Phoenix area? | |
| About your home: | I own my home |
| If there are child living in your household, what are their ages: | No children |
| Which do you prefer to care for (please check all that apply): | Adult Dogs |
| Do you have any experience with suckling’s that need to be bottle fed? If so, please explain |
Yes, and I never want to do it again! |
| Do you currently have pets? |
|
| Are they Spayed/Neutered? |
|
| Number of Cats | 1 |
| Number of Dogs | 7 |
| Other | 1 Parrot and 1 Chicken |
| Are they current on rabies vaccination(s)? |
|
| Are they current on booster(s)? |
|
| Are your dogs licensed? |
|
| Please check any diseases your household pets may have or had: | |
| Other diseases or illnesses | None |
| If you have had dog and/or cat diseases in your home, please list when: | n/a |
| Do you have an enclosed outdoor area? |
|
| How high is the barrier? | 6 foot block wall |
| Where will your foster animal(s) be housed? | Indoors with the rest of my pets |
| How long will you be able to foster an animal or litter? | indefinitely |
|
Created 26 Jan 2013 12:04:16 PM PUBLIC |
IP Address |
Updated 26 Jan 2013 12:06:16 PM PUBLIC |