DRHS Foster Application Form

Fostering Saves Lives!

Fill in the form below to apply for fostering for the Dubuque Regional Humane Society
Applicant Information

Application progress: page 1/5
Name

First NameLast Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Secondary Phone Number
Format: (000) 000-0000.
Date of Birth

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Contact:

First NameLast Name
Emergency Contact Phone Number
Format: (000) 000-0000.
Relationship:

Experience

Application progress: page 2/5
Occupation:
Employer
Regular working hours:
About how many hours per DAY are you able to spend with your fosters?
Have you ever fostered animals in the past?
If yes, what species and through what organization?
Please describe your previous animal handling experience: i.e. medical care, socialization, training, bottle feeding, weaning, etc.

Fostering Interests

Application progress: page 3/5
Why are you interested in fostering? Check all that apply:
Will you be able to return the animal to the DRHS after having cared for it for an extended period of time?
Are you willing and able to bring foster animal(s) in for routine medical and foster appointments as scheduled by you and the Foster Manager?
Describe your feelings about euthanasia of animals for health or temperament problems:

Verification and Consent

Application progress: page 5/5
We require one piece of identification (i.e. Driver's License) for all applicants
ID Type:
ID #:
By signing below, you confirm that all information is accurate

Home Visit Virtual

Submit video walkthroughs or photos of any and all areas the foster animals will have access to below.
Foster Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Upload Photos/Video of home

Cancelof
Upload Photos/Video of All Residential Pets (Owned cats or dogs)

Cancelof
OPTIONAL: Any Additional Comments
Should be Empty:

Applicant Information