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Foster Care Application
Completion of this application does not guarantee placement of an animal with the applicant. PMHS animals are assessed for placement with the foster home that best fits the animal’s needs.
Foster Care Application
Type of Foster Care interested in - Please select what you would be interested in fostering - Check all that apply
Pregnant Cat who will birth kittens in home
Mother cat / already has litter
Sick/Injured/Recuperating Cat
Cat/kitten with socialization needs
Hospice Cat
Rabbits/Small animals
Pregnant dog who will birth puppies in home
Mother dog / already has litter
Sick/Injured/Recuperating dog
Dog with behavior/training needs
Hospice Dog
Foster to Adopt situation preferred
Name of Specific Animal (If Applicable)
Foster Information
Name
*
First
Last
Date of Birth
*
MM
DD
YYYY
Spouse/Partner's Name
First
Last
Address (Physical)
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Spouse Phone (if applicable)
Email
*
Mailing Address (if different from above)
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Residence Type
*
House - Own
House - Rent
House - Live with Homeowner
Condo/Duplex - Own
Condo/Duplex - Rent
Apartment in Complex - Rent
Apartment/In-Law Suite Type - Rent
How many children (under 18) live in the home/visit often? What are their ages?
*
How many adults (over 18) live in the home?
*
Current Living Arrangements
*
I own my own home: House, Condo, Duplex, Mobile/land, Mobile in Park
Live with home owner
Rent: Apartment, House, Condo, Duplex, Mobile Home, Dorm
Name of Homeowner
*
First
Last
Homeowner's Phone
*
Name of Landlord
*
First
Last
Landlord's Phone
*
FOR DOG/PUPPY FOSTER INTEREST - Describe your property/yard space
Current Pets
Please list all the pets that you currently own. Write NONE if you do not own any pets. If you own multiple small animals such as rabbits, birds, etc. you can list them all under one line.
Pet #1 Name
*
Pet #1 Breed/Type
*
Pet #1 Age
*
Pet #1 Sex
*
Male, Intact
Male, Neutered
Female, Intact
Female, Spayed
N/A
Where is this pet kept?
Do you have another pet to add?
*
Yes
No
Pet #2 Name
Pet #2 Breed/Type
Pet #2 Age
Pet #2 Sex
Male, Intact
Male, Neutered
Female, Intact
Female, Spayed
N/A
Where is this pet kept?
Do you have another pet to add?
Yes
No
Pet #3 Name
Pet #3 Breed/Type
Pet #3 Age
Pet #3 Sex
Male, Intact
Male, Neutered
Female, Intact
Female, Spayed
N/A
Where is this pet kept?
Do you have another pet to add?
Yes
No
In the box below please provide all information on any additional pets:
What is the name of your current veterinarian clinic/hospital?
*
Foster Experience & Housing
Have you ever fostered an animal at an animal shelter before?
*
Yes
No
If yes, please go into detail below with shelter information and why you fostered -
How would you describe your experience with pets? Check all that apply
*
Never had a pet
Had childhood pet dog/cat/other
Had one or more as an adult
Have experience with high energy dog breeds
Have experience working with on-going medical problems with personal pet
Have experience working at a boarding kennel/resort/pet sitting service, etc.
Have experience working with behavioral problems with a personal pet
Have experience working in a veterinary hospital
I am a professional dog trainer
Have house trained a dog before
Have crate trained a dog before
Have been involved in the birth of an animal
Are you experienced with any specific medical conditions in pets? If yes, please explain
*
Where will this animal be housed when you are home?
*
Where will this animal be housed when you are NOT home?
*
How many hours a day will this animal be home alone?
*
Do you have any restrictions/preferences on what type of animals you can foster (size, breed, etc.)?
*
Do you have a seperate room available for your foster if required to separate per PMHS-CV guidelines?
*
Yes
No
Who will be the primary caregiver for this animal?
*
What is the average noise level of your home?
*
Low
Medium
High
Availability & Commitment
Are you able to bring foster animals to regular check-ups with our veterinary staff during open shelter hours?
*
Yes
No
Are you willing to bring foster animals to offsite local locations for medical appointments, meet and greets, etc. when required by PMHS-CV?
*
Yes
No
Certification Statement
*
I agree to receive and care for the foster pet in my home until the time the animal is ready to return to the shelter or is adopted. I will be responsible for feeding, daily hygiene, and providing a safe and clean environment; making sure it gets proper exercise and mental stimulation (that includes playtime); making sure the pet follows the vaccination schedule given by the shelter; transporting your foster pet to its veterinarian appointments if necessary. The shelter can provide food, litter, toys, bedding, etc. for foster pets which must be picked up at the shelter. The shelter also provides medical care for pets in foster care. All vaccines, tests, and spaying and neutering will be done through the shelter or a vet of the shelters choice. Any illnesses which arise should be immediately reported to PMHS staff listed in the handbook and will be assessed and handled as deemed necessary. Any vet visits which are not previously approved will not be covered by the PMHS. I will not sell or give away any animal in my care to a research facility, pet shop, dog breeder, or puppy mill, or to any other person or business. In the event that I am no longer able to care for the pet, I agree to immediately return any foster animal(s) in my care at that time, as well as all records and property belonging to PMHS. The length of time a pet is in foster care is at the sole discretion of the shelter and pets can be required to be returned at any time. I agree to adhere to any and all foster guidelines which are outlined in the foster handbook. I have completed this application to the best of my ability and knowledge. I have made no misstatements or misrepresentations. I understand a Shelter representative may need to visit my home for a home inspection before my foster application is fully approved. I authorize Pope Memorial Humane Society to contact listed veterinarians and landlords to investigate all statements in this application. Once approved and selected to foster an animal, all foster homes receive a Foster Care Handbook pertaining to the animal(s) you have brought home
Submitting this form constitutes as an electronic signature
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