Fostering

Pet Profile:

Please list any pets of our own, including species, breed, age & gender.

1.

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5.

Are all these animal’s vaccinations up to date?

YesNo

Volunteer Information:

Instructions Please check the type of animal(s) you are interested in fostering.

Dogs

PuppiesUnder socializedNursingSick dogs

Cats

KittensFeralBottle fed kittensSick cats

Small Animals

RabbitsGuinea pigsRats

Livestock

HorsesCowsFowlPigsOther

Reptiles & Snakes

Personal Information:

Are you 18 years of age or older? *

YesNo

Instructions Best time for a Mel’s Farm representative to visit your home?

Day of week: *

Time: *

Type of residence: *

HouseApartmentFarmTrailer

Do you have:

StairsBalconyElevatorFenced Yard

Are there children in the home? *

YesNo

Children's Ages:

Do you have access to a vehicle? *

YesNo

Are all members of your household in agreement regarding fostering? *

YesNo

References:

Please list 3 references:

Reference 1

Name *

Phone *

Reference 2

Name *

Phone *

Reference 3

Name *

Phone *

Have you ever been convicted of a Criminal Code, R.S.C. 1985, c. C-46, offence, an offence encompassed by the Provincial Offences Act, R.S.O. 1990, c. P. 33, including, without limitation, the Ontario Society for the Prevention of Cruelty to Animals Act, *

YesNo

Pet Profile:

Volunteer Information:

Personal Information:

References:

Reference 1

Reference 2

Reference 3

Verification

Annual Chocolate Chip Cookie Fundraiser

Sasha is ADOPTED

Diablo (Adopted) & PeeWee (Adopted)

Giant Clothing and Shoe Sale

Finn – Adopted