Application

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PLEASE NOTE: If your application is time sensitive, please call our office at 610-581-4141 between 
9 am & 5 pm EST.  
IMPORTANT: You will see at the top right of this form, that you are able to save this at any time and come back to it when it is convenient.  It is our recommendation that you save it after answering the first question and save it a couple of times throughout the process.  This way, if something happens to your connection you will not have to start over. 


































Please list all people living in the house full or part time - including yourself

































































Please List all pets living in your home.














Veterinarian Information, please make sure you give your veterinarian permission to speak with us (even if you don't have a pet now, we like to use your past veterinarian for a reference):










Please provide 2 references who you have known for at least 1 year and that can speak to your animal care experience to help facilitate the PACT Home Approval Process (veterinarians, groomers, trainers, neighbors, co-workers, friends) as well as 3 photos of your home: yard plus 2 inside of your home where the foster(s) would be spending most of the time.
Reference 1






Reference 2









































Pet Information:  (More than one pet? -  You will have an opportunity to add as many pets that need a foster home at the end of this section.)




























































































Emergency contact if we cannot get in contact with you? This will be your Point of Contact (POC) person who also will be responsible for taking possession of your pet if you are unable to do so on the appointed date.























Please provide 2 references who you have known you for at least 1 year and that can speak to your animal care experience and volunteer experience(veterinarians, groomers, trainers, neighbors, co-workers, friends):
Reference 1






Reference 2















 A PACT staff member will reach out to you shortly. Thank you so much for taking the time to complete this application. We look forward to working with you soon.

Warmly,

 Buzz Miller,
 Founder and President






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