CCHS Foster Care Application
Foster care application
Today's Date
Name
*
Address
*
City
*
State
*
Zip code
*
Home Telephone Number
*
Cell Phone
Work Telephone
Email
Foster Home Information
List all members of your household with their ages and how they will be involved in the care of the foster animal
List all members of your household with their ages and how they will be involved in the care of the foster animal
If you have any animals already in the home, please list their name, age, breed, sex and date of rabies vaccination (if known)
If you have any animals already in the home, please list their name, age, breed, sex and date of rabies vaccination (if known)
Describe where you will be keeping the foster animal, including how you will separate them from your own animals, if applicable:
Approximately how long, on an average day, will foster animals be left alone in the home (without people to monitor eating, behavior and using the bathroom)?
Please share your previous experience with animals
Are you currently or have you previously fostered for any other humane society?
No
Yes
If Yes, which one?
Anything else you would like to share about yourself or your experience?
Current Veterinarian Information
In order to be approved to foster for the Clay County Humane Society, all animals in your home must be vaccinated against rabies. Please consult your veterinarian about fostering. They may recommend additional vaccinations to protect your pets.
Name of Veterinary Clinic
Veterinary Clinic Phone Number
If needed, do you have approval to have a foster pet in your home?
No
Yes
Please list what animals you would be willing to foster in your home. Fosters could include young and adult animals, animals who are pregnant, or animals needing behavioral help, recovering from surgery, or needing medical treatment.
Please list all animals you would be willing to foster