HSSI Foster Application

Contact Information We require complete contact information so that we may reach you in the event you are approved for adoption.
Today's Date *
First Name *
Last Name *
Home Phone * This should be the primary phone we should use to contact you if needed.
Cell Phone
Work Phone
Email *
Street Address * Please enter your current postal mailing address. Include Apartment number or P.O. Box if necessary.
City *
State *
Zip Code *
Your Current Occupation *
I am at least 18 years of age (yes or no) *
Residence
Do you live in a
For your primary residence (where you will be keeping this pet), do you
If you rent, list any restrictions on pets. If none, please indicate "None."
Household
Please list all the names and ages of children living in your household.
Pets in the Household
If you already have pets, please list all of them. Include each animal's name, age, sex, and species (such as cat or dog).
If you have pets, are they all spayed or neutered?
If you have pets, what is the name of your current veterinarian?
If you have pets, what is the phone number for your current veterinarian? (We may call for their reference.)
Foster Preferences
What kind of animals are you willing to foster? (select all that apply)	Dog(s) Cat(s) Puppies Kittens Pregnant Nursing Motherless litter Medical Needs Behavior Issues
Would you consider fostering more than one animal at a time?
What does your ideal foster look like?
If all information above is the most up to date that it can be, please sign below and submit your application! Please allow us up to one week to respond. To sign with a touch enabled device, sign with your finger. To sign from a device without touch, click and drag the mouse pointer to create your signature. Use the "clear" button to retry a signature.
Signature *

Humane Society of Southern Illinois | 95 Humane Road, Murphysboro, IL 62966 | 618-457-2362

HSSI Foster Application

Contact Information

Residence

Household

Pets in the Household

Foster Preferences