Foster Care Request Pet Foster Care Request Form To request foster care for your pet(s), please fill out this order-enabled form. Please be sure to provide as much information about your pet as possible, so that we can match your pet with the perfect foster family. Once you submit this form, you will be taken to Paypal, our payment processing service to complete your order using credit card, e-check or debit card. If you prefer to pay by another method, please submit this form and call us to arrange payment toll-free at 1-888-720-3322. Administration Fee For Locating Foster Care (Per Pet)Please note: There is a $150 administration fee for locating and arranging foster care for your pet. This fee covers our costs in advertising for, and careful screening of potential foster homes for each pet. Price: $150.00 Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email Enter Email Confirm Email PhoneCellBest Time To Reach You : HH MM AM PM Pets*Please provide details about the pet(s) for which you wish to request foster care.NameTypeBreedAgeSex Pets2*Please provide details about the pet(s) for which you wish to request foster care.WeightSpayed/NeuteredHouse brokenGood with dogs?Good with cats?Good with children? Pets3*Please provide details about the pet(s) for which you wish to request foster care.Up to Date Shots?Health Issues?Behavior Issues?Special Needs? Please provide further explanation, if needed, for the items above.Please Describe Your Pet's PersonalityWhat is your home environment like?Please Tell Us A Little About Your Family:What are your pet's favorite toys, foods, activities?For What Reason(s) are you needing to place your pet(s) in foster care?Please describe what you are looking for in a foster family/home for your pet:What supplies and accessories will be provided with your pet?We recommend that you offer a small monthly amount to the foster care provider as a gratuity for their time and effort in caring for your pet of at least $100 per month. Please indicate whether you agree with this, and what monthly amount you would like to offer:Do you hope to stay in touch/visit with your pet in it's foster home? Yes No Unsure Additional Comments or InformationYouTube Video of Pet Please choose the appropriate Monthly Foster Care Plan below. Be sure to indicate the number of months for which foster care will be needed. If unsure, choose 1 month.I hereby state that I am the owner of the pet referenced above, and that I authorize Pet Rehoming Network to obtain pet foster care services on my behalf for the service fee detailed above. I hereby acknowledge that I have read and agree to the terms and conditions of service as set forth on the Pet Rehoming Network website. Authorized Signature* What is the sum of 6 + 6 = ?*Please enter a number from 11 to 13.
