Foster Application

This form is for potential fosters for To The Moon and Back Animal Rescue a foster-based rescue located in Quad Cities IA/IL. We couldn't do it without you all! But we need to always check and ensure the safety of our animals and fosters! Please fill out this form and we will be in contact shortly. Please email if you have any questions or concerns.

In order to be a foster, the following conditions must be met:
-Be over 21 years old
-Provide vaccine records for any animals in your resident
-Have your current pets spayed/neutered
-Provide identification and proof of current address
-Have knowledge and consent of your landlord (if applicable)
-Be able and willing to spend the time necessary to care for the dog
-Love doggy kisses, snuggles, and unconditional love
Name *
Your answer
Address *
Your answer
Phone Number* *
Your answer
E-mail *
Your answer
Is there a particular animal you want to foster? If so why? *
Your answer
Is there a particular animal you cannot foster? If so, why? *
Your answer
What type of home do you live in? *
If you rent, does your landlord permit pets? *
If you rent, does your landlord have breed or size restrictions? *
Please provide landlord name and phone number? *
Your answer
Do you have a fenced in yard? If so, please describe it. *
Your answer
If no, do you agree to keep all applicable pets on a leash? *
Do you currently have pets of your own? If yes, please describe (Age/Breed/Sex/UTD on Shots/Spay or Neuter). *
Your answer
If you don’t currently have pets, have you ever owned any pets in the past?
If yes, tell us about your pets and why you no longer have them:
Your answer
Why do you want to help rescue animals? *
Your answer
Makeup of household: Tell us how many adults, children, and ages. *
Your answer
Is anyone in your family allergic to animals? *
Who will be primarily responsible for the care of the animal? *
Your answer
How many hours per day will the animal be left alone? *
Your answer
Where will the animal be kept during the day/night? *
Your answer
Are you willing to house train a dog or litter train a cat if needed? *
Do you have an available crate or cage for the animal you wish to foster? *
Do you have a veterinarian that you use? *
If yes, please provide their name and phone number: *
Your answer
What pet names and last name are your records under?
Your answer
If necessary, are you willing to take the To the Moon and Back Rescue animal to an approved vet? *
Are you willing to have someone from To the Moon and Back Rescue visit your home prior to placing an animal with you? *
Are you willing to house a special needs animal or a senior animal? *
Are you willing to house an animal recovering from surgery and/or on medication? *
Will you be able to provide the foster animal with quality food? What brand? *
Your answer
Have you ever provided temporary care for a rescue animal before? If yes, please explain the situation. *
Your answer
Please list three references with phone numbers. Please do not include family members *
Your answer
All of the information I have provided on this application is true and complete. I understand that falsifying anything on this application or at any other time during the time I am providing foster/temporary care for To the Moon and Back Rescue, will prevent me from housing any other animals from To the Moon and Back Rescue and will result in returning any animals belonging to, To the Moon and Back Rescue. *
Please date to indicate signature *
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