BOND COUNTY HUMANE SOCIETY

FOSTER HOME APPLICATION

Name: ______

Address: ______

Street City State/Zip

Email Address: ______

Day Phone: ______Evening Phone: ______

Do you rent or own your home? ______. If renting, do you have permission in writing from the owner or landlord to keep an animal? ______

Landlord’s name & number: ______

Do you have children? _____ If yes, please provide sex and age? ______

______

Are all family members in agreement about fostering an animal? ______

Do you or any of your family members have any known allergies to dogs or cats? ____

If yes, please describe ______

Who will be the primary caregiver for the foster animal? ______

Type of animal you are willing to foster: (Please check all that apply)

Cat ___ Large Dog ___ Small Dog ___ Other ___ Please specify: ______

How many animals are you willing to foster at a time? ______

How much time will the foster animal spend alone? ______

Where will the foster animal be kept when you are not home? ______

Where will the foster animal sleep? ______

Do you have any other pets in your home? _____ If yes, please list below.

Name/Species
Breed/Age
Sex/Altered
Vaccination history
Heartworm Preventative

Do you have a regular Veterinarian? _____. If you currently have pets a veterinarian reference is required.

Name: ______Address: ______

Phone: ______

How much do you know about training and behavior programs?

______

What behaviors do you think you can’t tolerate or would be difficult for you to manage? ______

Would you be willing to answer questions from perspective adopters about the animal?

_____

Would you be willing to transport the animal and participate in adoption activities?

_____

Would you be willing to provide a quarantine facility for a minimum of 24 hours, maximum 10 days? _____

Are you willing to foster a special needs animal? _____

May we visit your home? _____

Do you agree to care for the animal in compliance with Bond County Humane Society standards and guidelines? _____

PLEASE PROVIDE A NON-FAMILY REFERENCE

Name: ______Address: ______

Home Phone: ______Work Phone: ______

Relationship: ______

Do you agree to abide by all applicable State, County and Municipal laws applicable to animals and their care? _____

Do you agree to take the animal to a veterinarian designated by BCHS for necessary treatment (at BCHS expense)? _____

Do you agree to release the pet to Bond County Humane Society when a suitable permanent home is found? _____

If approved as a BCHS Foster Home what date could you accept your first foster animal? ______

I certify that all the above information provided is complete and correct to the best of my knowledge.

______

Signature of Applicant(s) Date

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For BCHS Use Only

Vet Check: ______Date: ______Notes: ______

Landlord Check: ______Date: ______Notes: ______

Reference Check: ______Date: ______Notes: ______