Foster Home Sign-up Form

Foster Home Sign-up Form - Dog

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Thank you for your interest in fostering an animal from the Montgomery County Animal Care and Adoption Center! You are an important part of our mission to create a community where every animal is given a chance at a happy and healthy life. The questions in this document are designed to help us get to know you better so that we can find a foster animal that is the right fit for you. There are no right or wrong answers for any of these questions so please answer them completely and honestly as you can!
FOSTER VOLUNTEER INFORMATION
First name *
Last name *
Age *
Street Address *
City *
Zip Code *
Phone #1 *
Phone #2
Email *
HOUSEHOLD INFORMATION
Please list any other human residents of the home in which you live, as well as their ages and their relationship to you. Please include any roommates. *
Are any of the residents under 18 years of age? *
If so, what is the approximate age range of the child/children?
Has everyone in the household agreed to have a foster animal in the home? *
Is anyone in the household allergic to dogs, cats, or other animals? If so, what type of animal is the person allergic to? *
Please briefly describe your typical weekly schedule below with the approximate number of hours the foster animal will be left alone each day.
Monday:
Tuesday:
Wednesday
Thursday:
Friday:
Saturday:
Sunday:
Do you own your own home? *
If you rent, please provide contact information (name and phone number) for your landlord or leasing agency.
Landlords, insurance agencies, and home owners associations often have breed, weight, or animal number restrictions. Please speak with these agencies (if applicable) and list any restrictions.
Some agencies do not allow foster animals or require that a pet fee be paid. Please read and check the following statements.	I have confirmed that I am allowed by my landlord or leasing agency to have a foster animals in my home. I am aware that the MCACAC will not cover any fees associated with damages, pet deposits, or monthly pet fees and I am prepared to pay these fees.
ANIMAL INFORMATION
Are there any other animals living in the household? *
Please list all animals currently living in the household with their name, species, breed, age, and sex.
Are all animals in your household spayed or neutered?
Are you capable of keeping your foster animal completely separate from any resident animals should a temperament conflict or health issue arise?
Please list the name and contact information of the veterinarian who most recently cared for your current animals. Please note that all resident animals must be up to date on rabies and distemper vaccines and flea prevention before bringing a foster animal home.
	I agree to let a representative from MCACAC call my veterinarian and verify that my animals have received the proper vaccinations and that I provide recommended care.
ANIMAL EXPERIENCE
Have you ever owned an animal in the past? *
Please list how many and what types.
Have you ever fostered an animal through a shelter or rescue? *
If you have fostered before, please provide the name and contact information of the group through which you did so.
Do you have any animal experience other than owning a pet? (Examples: working at a veterinarian's office, boarding facility, laboratory, other shelter)
FOSTER ANIMAL PREFERENCES
Animals generally go into foster care because they are struggling to thrive in the shelter environment. What situations do you feel equipped to handle?	Behavioral issues Pregnant mother Lactating mother with offspring Orphaned neonates Shy animals Hospice care Injured animal Ill animal (non-contagious) Ill animal (contagious) Weaned animals High-energy animals Long-term fosters (over one month)

Are you willing and able to do any of the following activities for your foster animal?	Take to the vet Give medications Housetrain/litter train Transport to the shelter or shelter events Use basic positive reinforcement training techniques Follow instructions for any special care

Please describe where you plan to house your foster animal when you are at home.

Please describe where you plan to house your foster animal when you are away from home.

How do you plan to exercise your foster animal and provide mental stimulation? How much time do you have to provide exercise? Please note that foster dogs are NOT permitted to attend dog parks with unknown dogs.
TERMS AND CONDITIONS
By clicking submit or signing below I agree to the following list of terms and conditions.
I have read this application in its entirety and certify that all statements are truthful under penalty of perjury under the laws of the state of Virginia.
I certify that I have never been convicted of animal neglect, cruelty, or abandonment.
I understand that a representative from MCACAC will come to my residence for a home check before allowing me to bring home a foster animal.
I understand that foster animals remain the property of the MCACAC and I may not give custody of the animal to another person or entity until expressly permitted to do so by a staff member of the MCACAC.
I understand that all decisions about the placement or disposition of the animal will be made by the MCACAC.
If accepted as a foster home, I agree to read the foster care handbook thoroughly and abide by all policies and procedures outlined therein.

Drivers License Number *
I certify that the above information is true and complete to the best of my knowledge. *

Foster Home Sign-up Form - Dog

FOSTER VOLUNTEER INFORMATION

HOUSEHOLD INFORMATION

ANIMAL INFORMATION

ANIMAL EXPERIENCE

FOSTER ANIMAL PREFERENCES

TERMS AND CONDITIONS