Foster Application Form

Full Name*

First NameLast Name

Date of Birth*

E-mail*

Phone Number - Home/Cell*

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you have a preference in sex of foster?

MaleFemaleNo Preference

What species are you interested in fostering? (Check all that apply)*

DogsCatsOther

Is there a specific animal you're interested in fostering?

Are you interested in fostering to adopt? (Applicable adoption fees apply)

YesNoDon't know

Which of the following special needs would you be willing to provide care for? (Check all that apply)

Do you have any experience with any of the following? (Check all that apply)

Do you live in a:*

Do you:*

OwnRentLive with ParentsOther

If renting: Do you have your landlord's permission to have the type of animal you are interested in fostering?

YesNo

If renting: Please indicate landlord contact information

Describe any limitations on the size, type, and/or number of animals in your home.

Please list all people living in the household.(Include name, relationship, and age)*

Do all members of the household accept the idea of fostering animals?*

YesNo

Does any member of your household have animal allergies?*

YesNo

If you answered yes to the question above, please describe.

Does anyone in your household smoke inside?*

YesNo

If you answered yes to the question above, how often do they smoke inside?

Please list all pets currently living in your home. (Include name, species, breed, sex, spay/neuter status, age) *

Do any of your current pets have any aggression or behavioral quirks? If so, please describe.

Will your foster animal(s) be introduced to any of your current pets at any time during their stay?

YesNoNot applicable

Are your current pets up-to-date on: heartworm preventative, annual vaccines, rabies vaccine?

Are your current pets on a flea preventative? What kind?

Do your current pets take any other medications? Please describe.

Do any of your pets currently live outside?

YesNoNot applicable

If so, where?

Where do your current pets stay when no one is home?

Are you currently fostering any animals for another animal shelter or rescue group?

YesNo

Has a pet died on your premises due to Distemper, Parvo, Feline Leukemia, or an unknown cause in the past year?

YesNo

How many hours will your foster pet(s) be home alone on a typical day?

What sort of behaviors do you consider unacceptable?

Where will the foster animal(s) stay when no one is home?

Where will the foster animal(s) sleep?

Do you have a completely fenced yard?

YesNoPartial

If so, how high is the fence?

Do you mind if someone interested in adopting your foster pet visits your home?

YesNoOther

Do you have an estimated timeframe or any constraints on when you are able to foster?

Please list your current vet and their phone number.

Vet NameVet Phone Number

Reference #1*

Full NamePhone NumberRelationship

Reference #2*

Full NamePhone NumberRelationship

Reference #3*

Full NamePhone NumberRelationship

By submitting this application electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any animal from Bartholomew County Humane Society fostered by me.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Bartholomew County Humane Society and its members from any claims, damages, costs, or actions incurred because of the care or actions of the foster animal.

I accept full responsibility for the animal(s) actions at all times, and release Bartholomew County Humane Society from any liabilities or damages that may be incurred because of fostering such animal(s).

I agree to have Bartholomew County Humane Society complete reference call checks and conduct a home visit inspection to be able to approve my foster application.

I agree that if I'm unable to foster the animal(s) anymore that I will return the animal(s) to Bartholomew County Humane Society and try to give Bartholomew County Humane Society a 2 week period to try to prepare a space at the shelter or find another suitable foster for the animal(s).

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