UCHS Caring Companions Profile

Thank you for your interest in sharing your home with a shelter animal!

Please note that this form is for only our Caring Companions senior foster program. If you are looking to adopt, please visit the Adoption section of our website. If you are submitting this form, please do not submit an Adoption Profile as well. Someone will be in contact soon.
Applicant Information
Your Name*

First NameLast Name
Email*
example@example.com
Phone*
Format: (000) 000-0000.
EmailPhone
Address*

Street Address

Address Line 2

CityProvince

Postal Code
All program participants must provide an emergency contact who could be called upon to assist/support if needed. This could be adult children or grandchildren, a friend, etc.
Emergency Contact Name*
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Questionnaire
Short term (weeks or months) - just until the animal is adopted into its forever homeLong term - as long as I am able to care for my shelter pet
2. Are there any upcoming dates when you will be unable to foster?*
CatDogSmall Animal
4. My ideal foster pet is ... (select all that apply):
Young (under 3)Adult (3-8)Senior (8+)No age preferenceMom and kittens
MaleFemaleNo preference
SmallMediumLarge
Good with childrenGets along with catsGets along with dogsGood with visitors
Low maintenanceQuiet / calmPlayful / activeAffectionate / cuddlyCan be left alone during the day
YesNo
6. Describe where the foster animal will be housed:*
7. Tell us about the members of your household - People (# adults, children):*
Tell us about the members of your household - Animals (cats, dogs, other):*
YesNoN/A - I do not have any pets
YesNo
If yes, please describe:
YesNo
YesNo
11. Is there anything else you would like to share?
Acknowledgement
I. This animal will reside in my home. I will provide him/her with adequate food, water, shelter, access to clean litter box, exercise, and affection. I will pay for day to day care of my shelter pet. I will notify UCHS immediately if my foster pet is unwell, injured, or may require medical care. UCHS is responsible for medical care of this animal.II. I agree to notify UCHS if, at any time, I am no longer able to care for my pet, at which time the pet will return to the care of UCHS.III. I have never been subject to legal action for abuse or cruelty to, or neglect of animals. I have never owned an animal which has been confiscated by any animal control or humane organization for violations of provincial or local animal control regulations or animal adoption agreements.IV. All the information I have given above is true and complete. I understand that a false statement may disqualify me from further consideration as a foster or result in dismissal. The Upper Credit Humane Society reserves the right to decline any application.
Applicant Signature*
Date*

MonthDayYear
Date
Should be Empty:

Applicant Information

Questionnaire

Acknowledgement