GCHS Foster Application

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This questionnaire is intended as a guide to assist you in analyzing all the ways a foster animal will impact your life, and also to determine which animal is the right match for you and your lifestyle. All of the questions concern various aspects of fostering that should be given serious consideration before deciding to share your life with any foster addition(s). The information provided on this application will help us to find the best possible match between you and the pets available through the Grant County Humane Society. Completed applications do not ensure foster approval for specified or any animal.

Date *

Animal Name

Which animal type are you considering fostering?

Dog

Cat

Dog or Cat

Clear selection

Foster or Foster To Adopt *

Foster

Foster To Adopt

Name *

Address *

City, State, Zip Code *

Telephone *

Email *

Employer *

Length of Time Employed *

Residence *

Rent

Own

Describe your yard

No yard

Unfenced yard

Partly fenced

Completly fenced

Landlords Name and Telephone

Does Your Lease Allow Pets?

Yes

Clear selection

Are there children in the home? *

Yes

Ages of children in the home

Please list any other pets you currently have in your home

Are current pets spayed/neutered and up to date on vaccines? GCHS requires all animals currently residing in your household to be up to date on vaccinations. You will be asked to provide vaccinations records. *

Do any of your pets have behavioral concerns/chronic illnesses?

Yes

Clear selection

If yes, please explain

Have you had any other pets in the past? *

Yes

What kind of pets?

If yes, where are they now?

How will you keep fostered animal(s) and personal pets separated? (This is for while they adjust to each other- not permanently) *

Why do you want to foster animals? *

Are you able to feed nursing age kittens every four (4) hours day and night as needed? *

Yes

Have you taken any training classes? *

Yes

How long are you able to foster an animal? *

My household is able to foster?

Nursing mother cat and babies

Kittens

Cat: recovering from injury/surgery

Cat: special behavioral needs

Kitten bottle babies

Adult cats

Cat : Special medical needs

Cat: Hospice

Nursing mother dog and puppies

Puppies

Dog: Recovering from injury/surgery

Dog:Special behavioral needs

Puppy bottle babies

Adult dog

Dog: Special medical needs

Dog: Hospice

Holiday foster

Clear selection

How much time can you devote to foster care? *

How many hours will the fostered animal be left alone? *

Would the animal(s) be kenneled? *

Option 1

Other:

If yes, for how long?

Name of current veterinarian and telephone number *

References

Please list 2 NON RELATIVE references that we may contact on your behalf. This should be someone that knows you and can provide insight on your character, how you feel about pets, and how you treat them etc. Please notify them of our intentions to call as that will accelerate the application process.

Reference #1(Non-Relative) : Please include name, phone number, and how they know you *

Reference #2(Non-Relative) : Please include name, phone number, and how they know you *

Signature

I understand by signing this contract, I assume all the rights and responsibilities as a fosterer if approved for fostering.

I understand that I will be responsible for care of the animal and providing adequate space, shelter, security, warmth, wholesome food, free access to drinking water, exercise as required, and generally care for the animal.
I understand that I will need to administer such medication as the Shelter shall info9rm the Fosterer necessary for the animal. Fosterer will ensure the animal receives any veterinary treatment it may require in the event of an emergency.
The Fosterer should ensure the animal is taken to the vet notified at the time of fostering: Lake Region Small Animal Center in Elbow Lake, MN.
Allow a board member of the Shelter access to the fosterer's home at all reasonable times for the purpose of visiting the animal
The animal shall remain at the given address throughout the initial period
Provide a brief written summary concerning the animal's behavior and attitude while in the Fosterer's care if required by the shelter.
Bring animal to all scheduled vet appointments. If appointment is missed or you fail to bring animal to an appointment/continually ask to reschedule, fostering will be terminated, and animal will go back into the shelter's care.

The shelter agrees to pay all necessary veterinary fees incurred for the animal that arise during the period of this agreement, except for such veterinary fees that may arise as a direct consequence of either negligence or deliberate act of the Fosterer.

Grant County Humane Society will not be held liable for any damages, i.e. personal property, accidents, bodily injury, etc., by the animal(s) while in your care. The Fosterer shall ensure that they are adequately insured to cover any eventuality which may occur while the animal is in their possession.

It is agreed that the animal be cared for, receive all necessary vaccinations as deemed by the Lake Region Small Animal Center.
Completion of this contract does not guarantee foster approval.
My signature represents my consent to a background check and to check vet references. I further vow that the information I have provided above is true.

Signature: Applicant Please Type full name and date *

Submit

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