Foster Application

Full Name *

First Name Last Name

Age

E-mail *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number - Home

Area Code Phone Number

Phone Number - Cellular

Area Code Phone Number

Phone Number - Work

Area Code Phone Number

Do you live in a: *

Do you: *

Own Rent Live with Parents Other

If Renting, are there restrictions on # of pets, size, breed, etc? Also provide Landlords name and phone #.

Household Setting

Rural City

Describe the Activity Level in your Home

Busy/Noisy Moderate Comings/Goings Quiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age) *

Have you, or anyone in your household, ever been convicted of domestic abuse, child neglect, or animal abuse or neglect?

Yes No

Does Anyone in your Household have Allergies to Animals?

Yes No

Are all members of your Family agreeable to Fostering an animal?

Yes No

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Sex, Living/Deceased)

Are your pets fixed, UTD on vaccines, heartworm and flea preventative?

Are your current pets friendly with other cats, dogs, both, or neither?

Have your cats been tested for FELV/FIV?

Would you be willing to have an HSSC Member call your veterinarian for a reference check? (Please authorize vet to speak with us)

Yes No

Veterinarian Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number

Are you willing to foster a dog or cat?

Dog Cat Either

Do you have a preference in the sex of foster?

Male Female No Preference

What age would you consider fostering?

Young Adult Puppy or Kitten Senior

How may are you willing to foster at one time and for how long?

Please describe the type of dog or cat you are willing to foster (Please include breed(size), bottle fed, sick, pregnant, litter, behavioral issues, etc) We always want to make sure we have the best fit for our foster homes *

Have you ever fostered before? If so, what organization?

What types/breeds of animals have you fostered before?

Are you willing to take your foster dog or cat to an approved HSSC veterinarian appointments at a convenient time for you?

Yes No

If No, please explain

Are you willing and able to take the foster to scheduled adoption events including weekends?

Yes No

Are you willing and able to medicate your foster, even if it is just a monthly heartworm preventative?

Yes No

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?

Yes No

What methods do you plan on using to discourage unwanted behavior and encourage good behavior?

Have you had any experience with with an emotionally or physically neglected or abused dog?

Yes No

If Yes please explain

Are you willing to use a crate for a dog or cat if recommended?

Yes No

Do you have a fenced yard?

Yes No Partial

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

How many hours in a day would the foster be left alone? *

Where will the foster be kept when unsupervised or left alone?

What are you plans to exercise your foster? Please list any parks near by or trails, how many walks a day, approximate length, activities such as agility *

A rescued animal has unknown medical and behavior history. They will require time to adust and learn what is expected of them in their new environment.

By sending this 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 Humane Society of Saginaw County(HSSC) animal 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 HSSC and it's 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 HSSC from any liabilities or damages that may be incurred because of fostering such animal(s).

I agree to have HSSC 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 HSSC and try to give HSSC a 2 week period to try and find another suitable foster for the animal(s).

We evaluate each home indivually, and even though you may not meet all requirements, you may still be able to foster a pet for HSSC.

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