Applicant's First Name *
Applicant's Last Name *
Home Phone
Please use the following format 248-555-1212
Cell Phone *
Email Address *
Please enter carefully as this is the main way we will contact you
What is the best way to reach you?
Cell Phone
Home Phone
Email
Street Address *
Apartment Number (if applicable)
City *
State *
Zip Code *
Drivers License Number *
Are you at least 18 years of age? *
No Yes
Have you fostered for us in the past?
No Yes
How long are you willing to foster a pet
What kind of animal(s) are you interested in fostering? Check All that Apply *
Medium / Large Adult Dog (Greatest Need)
Adult Cat
Medical Needs Dog
Medical Needs Cat
Puppies
Kittens
What is your preference for activity level for a dog foster?
Running Buddy
Couch Potato
Any Activity Level
Male or Female?
Male
Female
It Doesn't Matter to me
Age Range - Check all that apply
Young
Senior
Infant
It doesn't matter to me
Are you able to separate a foster animal from other resident pets and people should an issue arise? *
No Yes
What supplies would you need HSCCL to provide for your foster pet? Check all that apply
Crate
Food
Leash
Collar or Harness
Food Bowl
Water Bowl
Toys
I don't need anything, I'm all set
Please select your current residence type.
House
Apartment
Condo
Townhouse
Mobile Home
Other
If you answered "other" above, please explain here:
Do you own or rent your home?
Own
Rent
Someone else owns the Home
Someone else rents the Home
If you rent, does your landlord and lease allow pets - including foster pets?
Yes
No
Unsure
N/A
Including yourself, how many people live in your household?
Please list the ages & relationship of those who live in your home.
Do you have kids under 12 years of age? *
No Yes
Does anyone in your household have allergies to dogs/cats?
No
Allergic to Dogs
Allergic to Cats
N/A
Is everyone in your household aware that you are planning to foster a pet?
Yes
No
N/A
Veterinarian's Name
If you have never owned a pet please tell us where you would go.
Do you own other pets at the current time?
No Yes
If yes, please list their names, type of animal (dog/cat), ages and temperament
Are your pets current on their vaccinations?
Yes
no
n/a
If no, please explain:
Are all of your pets spayed/neutered/fixed?
Yes
No
N/A
Will your foster pet be predominantly living inside, outside, or both?
Inside
Outside
Both
Do you have a completely fenced-in yard? If so, what kind of fence?
Wood
Chain Link
Electric
Plastic
Iron
Other
Other (I do not have a fenced yard)
If you answered "other" above, please explain:
If you do not have a fenced yard, how will you let the animal out?
Have you ever been convicted of abuse or neglect of a child or animal?
No Yes
If yes, please explain:
I understand that the Humane Society of Cedar Creek Lake (HSCCL) is the sole and rightful owner of the animal(s) in foster care. All decisions regarding any and all foster pets are to be made by HSCCL staff *
Yes
No
I understand that I do not have the authority to give, transfer, or adopt out custody of a foster animal(s) to any other person, organization; unless approved the HSCCL coordinator or designated personnel. *
No Yes
I understand that animals that appear healthy may be infected and not show any symptoms until after I have brought them into my home. *
No Yes
I agree to notify HSCCL immediately if a foster animal sustain illness or injury or becomes lost. *
No Yes
I understand that medical services will be provided by HSCCL animals at the recommendation of the HSCCL veterinarian. *
No Yes
I understand that I am NOT authorized to take the animal to my own veterinarian for medical treatment without authorization. *
No Yes
I understand expenses that I initiate without approval will not be reimbursed. *
No Yes
I understand that HSCCL may inspect my home if I am housing a foster animal. *
No Yes
I agree to keep my own pets current on all vaccinations. *
No Yes
I understand that I am NOT authorized to move an animal to another location without prior approval from HSCCL. *
No Yes
I agree to return the foster animal(s) within 24 hours of a request by any member of the HSCCL staff. I also agree to notify HSCCL with a minimum of 24 hours notice if I will be returning my foster pet(s). *
No Yes
I agree not to use choke collars, prong collars, electric shock collars, or other abrasive methods on my foster animal. *
No Yes
I understand that Fostering is not without risk. I understand that HSCCL is not responsible for damage to personal property caused by foster animals. Illness or injury to my own animals or personal injury caused by foster animals. *
No Yes
