Foster Parent Application Form
Thank you for your interest in becoming a foster parent with The Humane Society of Jackson County! It is the goal of The Humane Society of Jackson County, Inc. ("HSJC") to place pets with responsible individuals and families who will provide a loving and safe environment for animals awaiting adoption. The information you provide helps our volunteers match you and your family with the right foster pet.
Please remember that the completion of an application form does not guarantee a foster pet. HSJC reserves the right to refuse the application of anyone for any reason.
Please complete the following application form and submit it. once your application is reviewed, you will be contacted by an HSJC volunteer.
Applicant Information
Name
Address
City
State
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Home Phone
Work Phone
Cell Phone
Best time to call
Email
Are you over the age of 18?
Yes
No
Do you qualify as a Senior Citizen (over the age of 65)?
Yes
No
Personal Reference:
Name:
Address:
Phone:
Residence
I live in a:
House
Apartment
Condo
Mobile home
Other (please explain below)
I
Rent
Own
If you rent, do you have your landlord's permission to keep a pet?
Yes
No
Landlord's name
Landlord's phone
Is there a restriction on the type, size or number of pets that you may keep?
Yes
No
If yes, please explain:
How long have you lived at this residence?
Do you have a fenced-in yard?
Yes
No
If yes, height & type:
Are you planning to move in the near future?
Yes
No
If yes, when?
Household
List persons in household:
Adults:
Children (please specify ages):
Is anyone in your household allergic to pets?
Yes
No
If yes, please explain:
Yes
No
How would you describe your lifestyle?
Active (I enjoy travel, hiking, sports)
Homebody (I enjoy gardening, reading, watching TV)
Other (please describe below):
Do you currently own a pet?
Yes
No
If yes, fill out the following fields in as much detail as possible (Type of Pet, Breed, Male or Female? Age of Pet, Is this pet spayed or neutered? Is this pet current on vaccinations? Is this an inside or outside pet?):
Pet 1:
Pet 2:
Pet 3:
Pet 4:
Have you ever acted as a foster parent?
Yes
No
If yes, please explain:
Have you ever given up a pet?
Yes
No
If yes, please explain:
Do you have a current veterinarian?
Yes
No
If yes, please provide the following information:
Name
Address
Phone
How many hours, on average, will the pet spend alone?
Where will the pet spend the day?
inside only
outside only
both
If inside, will the pet stay in a crate?
Yes
No
If outside, will the pet stay in a fenced yard?
Yes
No
Who will be responsible for the daily care of the pet?
How much time per day will you spend exercising and playing with your pet?
Who will care for your pet when you travel or in an emergency?
Name
Address
Phone
Pet Preferences
What type of pet are you interested in fostering?
Dog
Cat
Other
If other, specify:
Breed:
Color:
Size (for dogs):
under 25 lbs
26-50 lbs
51-75 lbs
76+ lbs
Gender:
Male
Female
Age:
youth
adult
senior
Personality traits:
Is there a specific foster pet that you are interested in? If so, please give as many details as possible:
Commitment
Are you aware that the cost of fostering a pet is often at least $
per month?
Yes
No
Are you willing to commit to fostering a pet for at least six (6) months?
Yes
No
If you foster a pet that has not yet been housebroken or obedience trained, are you willing to devote the time to do so?
Yes
No
Are you willing to allow an HSJC volunteer to visit your home before you become a foster parent and during the time you are a foster parent?
Yes
No
Have you ever applied to foster a pet from HSJC?
Yes
No
If yes, please explain:
How did you hear about The Humane Society of Jackson County, Inc.?
Jackson Herald
The Paper
www.HSJC.com
Critter Magazine
www.petfinder.com
Friend
Adoption Event
Other (please explain below)
If other, specify:
By submiting below, I certify that all of the information that I have given on this Foster Parent Application Form is true and complete, and I understand that falsification of any of this information may result in the rejection of my application or the removal of a foster pet from my possession.
Privacy Policy:
The Humane Society of Jackson County, Inc. is committed to maintaining your confidence and trust. It is our policy that the personal information you voluntarily provide to us is stored in a secured location, is accessible only by designated volunteers and is used only for the purpose for which you provide the information.
Jackson County Humane Society © 2008
