Foster Application

To be considered for Foster Care you must meet the following:

• Be at least 21 years of age.
• Have legal identification with current address (we will confirm).
• Be able to verify you are allowed to have pets where you live.
• Be willing and able to bring the foster animal to adoption events and/or medical clinics upon request.
• Be willing and able to meet with JCHS representatives in order to transfer the foster animal.
• Be willing to surrender the foster animal upon request.
• Be willing to give updates on health/temperament/training on a weekly basis.

JCHS has the right to refuse any person at any time.

First Name: *
Last Name: *
Street Address: *
City: *
State: *
Zip Code: *
How long have you lived at this address? *
Home Phone: *
Cell Phone: *
Work Phone:
Email Address: *
Do you own or rent? *	Own Rent
Name and phone # of landlord if renting or leasing:
Type of home: *	House Apartment Mobile Home Other
If renting or leasing will you provide written permission from the landlord to have pets?	NoYes
Are there any neighborhood homeowner restrictions that need to be considered and if so what? *
Occupation: *
Employer:
Work days and hours:
Do you have a fenced yard? *	NoYes
Type/Height:
How would you describe your household? *	Active Quiet Other
Name(s) of other adults in household: *
Do you have any children living in your home? *	NoYes
If yes, please list their names and ages:
Do you have any children visiting your home on a regular basis? *	NoYes
If yes, please list their names and ages:
Do any members of your household have allergies? *	NoYes
Do you have a room in your home where the foster animal can be kept isolated from family pets? *	NoYes
If yes, please describe the location:
Are all household members in agreement with bringing home a foster animal? *	NoYes
When and how long are you willing to foster? *
Where will the foster animal spend most of its time? *
Are you willing to allow a JCHS representative to do a home check? *	NoYes
Which pets are you willing to foster? Please check all that apply: *	Adult Cat(s) Mom cat with litter Kittens Kittens who need bottle feeding Special needs cat(s) Adult dog(s) Mom dog with litter Puppies Puppies who need bottle feeding Special needs dog(s) Horse Livestock Other
How many hours per day will your foster animal be left alone? *
Where will your foster animal stay during the day? *
Where will your foster animal stay at night? *
Have you had any pets in the past? *	NoYes
How long did you have the pet?
Please list all veterinarians used in the last 5 years (Name, Address & Phone #): *
Do you have any pets now? *	NoYes
If yes, please list Name, Age, Gender, Species and whether spayed/neutered for EACH animal currently in the home:
Are your current pets spayed or neutered *	Yes No N/A
Are your pets current on their vaccinations? *	Yes No N/A
Is there anything else you would like us to know?
Reference #1 - name, phone # & relationship to you: *
Reference #2 - name, phone # & relationship to you:
JCHS CANNOT GUARANTEE THE HEALTH, TEMPERAMENT, OR TRAINING OF THE ANIMAL. JCHS DOES NOT KNOW THE COMPLETE HISTORY OF THIS ANIMAL AND THUS OFFERS NO WARRANTY OR REPRESENTATION OF ANY KIND REGARDING THE HEALTH, DISPOSITION, OR SUITABILITY AS A DOMESTIC PET. FURTHER, THE FOSTER AGREES TO RELEASE JCHS OF ANY LIABILITY FOR ANY HAZARD OR DAMAGE IT MAY PRESENT TO ADULTS, CHILDREN, OTHER ANIMALS, OR PROPERTY ONCE THE DOG IS IN HIS/HER POSSESSION. I understand a JCHS representative may visit my home for a home inspection before my foster application is approved. I understand that if I am approved for fostering I will also need to carefully read the “Foster Care Agreement” which is a separate document from this “Foster Care Application”. The Foster Care Agreement represents the legal contract between a foster caregiver and The Jefferson County Humane Society and Jefferson County Animal Shelter. I understand that if I am approved to foster an animal, I must review the Foster Care Agreement, agree to the terms of the Agreement, and sign the Agreement before I can take my foster animal home. I have read this Application in its entirety, and I certify the answers to this questionnaire to be true and that any false information may result in nullifying the foster agreement. I make this statement under penalty of perjury under the laws of the state of Ohio.
By typing your name you are asserting that all information provided in this application is true and correct: *
Date: *
Upon submitting your Foster Application you will be redirected to our Online Orientation Video and Questionnaire. You must watch the Orientation Video and complete the short quiz in order to become an approved JCHS Foster Care Volunteer. Thank you!