Foster Care Volunteer Application Stanton Shelter 455 Stanton Christiana Rd. Newark, DE 19713 Contact Volunteer/Foster Coordinator at 302-998-2281 Contact InformationName* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Phone*Work PhoneCell PhoneEmail* Enter Email Confirm Email Other InformationDate of Birth* Age*Occupation / Employer*Housing status*Rent apartment or homeOwn house or condoLive with parentsPlease provide your landlord’s name and phone number:*Do you have a fenced yard?*YesNoDo you have children in your household?*YesNoHow many children?*Ages of children:*Do children ever visit your household?*YesNoHow often do children visit your household?*Please list the current animals in your household (Name, Species, Sex, Neutered, Age)Which type(s) of animals can you foster?* Dogs Cats How many hours per day would your foster pet be home alone?*Please enter a value between 0 and 24.Which type(s) of foster care are you interested in?* Bottle feeding Adolescents (4 months - 8 months) Adult (8 months and older) Mother with litter Foster to Adopt/Other If interested in foster to adopt, please note name of animal here.*What amount of time could you foster for?*1 Week2-3 Weeks1 Month +Foster to adoptDo you have any previous foster experience?*YesNoPlease describe previous foster experience*ReferencesPlease provide three personal references:Reference 1 - Name*Reference 1 - Relationship*Reference 1 - Phone*Reference 2 - Name*Reference 2 - Relationship*Reference 2 - Phone*Reference 3 - Name*Reference 3 - Relationship*Reference 3 - Phone* If applicable, please provide a veterinary reference:Veterinary Reference - NameVeterinary Reference - PhonePost Title This iframe contains the logic required to handle AJAX powered Gravity Forms.