WRHS Foster Form

White River Humane Society Foster Application
Name *
Date *

Month Day Year
Date
Address *
City, State, Zip *
Home Phone *
Cell Phone *
Email *
Date of Birth *
Other People Who Live in your home? Include Names and Ages *
What vet do you use? What is their phone number? *
Have you ever provided foster care to animals before? *

Yes No
If Yes, when and what kind of animals? *
Why do you want to be a foster parent volunteer for WRHS? *
As a foster parent, you will be required to keep your foster dog(s) on a leash or enclosed within a fence adequate for the animal or in a home at all times. Foster cats must be kept inside at all times. By initialing in the box, you acknowledge that you will abide by these provisions. Initial: *
Will you be able to bring the pet(s) to adoptions? *

Yes No Depends/Possibly
What period of time are you willing to foster? *

Weeks Months Until Adopted
If you have limits regarding a fostering commitment, please explain: *
Do you have any experience caring for any of the following: *

Sick Animals Injured Animals Puppies Kittens Behavior Problems None Other
Do you have any experience giving medication to animals? *

Pills Eye Cream Ear Medicine Liquid Medicine Shots None Other
How long will the pet be left alone each day: *
Do you rent or own? If you rent, name of landlord and phone number: *
Do you have permission from your landlord to have an animal and/or foster? *

Yes No N/A
Do you have a fenced yard? *

Yes No
If yes, how high is the fence and what type is it?
Please describe the general area where your foster pet(s) will be kept: *
Additional Comments:
What are you interested in fostering? Please check all that apply? *

Older Dogs Adult Dogs Injured Dogs Dogs with Illnesses Dogs with Behavior Problems Dogs with Special Needs (Deaf, Blind, Etc.) Puppies with Mother Weaned Puppies Bottle Orphaned Puppies Pregnant Dogs Older Cats Adult Cats Cats with Injuries Cats with Illnesses Cats with Special Need (Deaf, Blind, Etc.) Weaned Kittens Bottle Orphaned Kittens Kittens with Mother Pregnant Cats Other
While you are caring for foster pets, we will contact you from time to time to check on the pets' progress and address any concerns you may have. WRHS reserves the right to remove the pet(s) from a foster home if WRHS has any reason to believe that the health or welfare of the pet(s) is in jeopardy. If for any reason the foster parent cannot fulfill their fostering duties, the pet(s) must be returned directly to a WRHS representative. If the foster parent decides to adopt the pet(s) they are fostering, they must discuss this with management and be subject to the adoption approval process and appropriate adoption fees. *

Clear
Date *

Month Day Year
Date
If you have dogs, please list Name, Breed, Age, and whether Spayed/Neutered: *
Do any of your dogs have temperament or health problems to make it difficult to be a foster parent? If yes, please explain: *
Is/are your dog(s) indoor, outdoor, or indoor/outdoor? *
Are all vaccinations and heart worm medications up to date? If no, please explain? *
If you have cats, please list Name, Breed, Age, and whether Spayed/Neutered: *
Do any of your cats have temperament or health problems to make it difficult to be a foster parent? If yes, please explain: *
Is/are your cat(s) indoor, outdoor, or indoor/outdoor? *
Are all vaccinations up to date? If no, please explain? *
Do you have any FIV or FeLV cats in your home? *

FIV FeLV-Feline Leukemia What are these? None in the home-Cats are tested. None in the home-Cats have not been tested. Other-Explain:
Has there ever been Parvo outside or inside the home or on the property? *

Yes in Home Yes on Property Yes in home and on property No I don't know what Parvo is. Unsure: Please Explain:
I understand that if the information provided on this application is found to be false/incorrect, I will surrender the pet(s) to WRHS upon demand. I agree to abide by WRHS guidelines and return the pet if I cannot keep it and to notify WRHS immediately if the pet is lost, shows signs of health issues, or dies. I agree to allow a representative of WRHS to inspect the home environment and yard, and if any violations of the contract are evident, I agree to allow the agent of WRHs to remove the pet from the premises occupied by me, and entry show not constitute a trespass. I certify that the information provided is true and correct. *

Clear
Date *

Month Day Year
Date
Thank you very much, and we look forward to working with you.
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