Foster Care Application

Name *

Street Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Housing Ownership *

Own

Rent/Lease

How long have you lived at your current address? *

Residence Type *

Landlord's Name

Landlord's Phone Number

Apartment Complex Name (if applicable)

Size of Yard *

Small

Medium

Large

Is your yard fully fenced? *

Yes

No

Type of Fence (if applicable)

Wooden

Chain-link

If your yard is not fenced, how do you plan on containing the foster animal(s) when outside?

Please list all household members and ages *

Number of children under 18 in household *

Are you currently employed? *

Yes

No

If yes, do you

Work from home

Work outside the home

If yes, do you work

Part-time

Full-time

Number of hours spent away from home on an average day

Do you have pets of your own? *

Yes

No

If yes, please describe your current pets

Please include your pets' name(s), breed(s), age(s), gender, if they are spayed/neutered and if they are current on their vaccinations/city license.

What animals are you interested in fostering? (Please select all that apply) *

Nursing cat (4-8 weeks of care)

Orphaned kittens (1-8 weeks of care)

Injured/sick cat (2-6 weeks of care)

Under-socialized cat (2-6 weeks of care)

Nursing dog (4-8 weeks of care)

Orphaned puppies (1-8 weeks of care)

Injured/sick dog (2-6 weeks of care)

Under-socialized dog (2-6 weeks of care)

How many animals are you willing to foster at one time? *

1

2-5

6+ (larger litter)

How often would you like to foster? *

1-6 times a year

Once/month

Call me anytime

Emergencies only

Do you have any prior experience with the type of foster care you are willing to provide? *

Yes

No

Do you have a confined area where foster animal(s) can be isolated for health reasons? *

Yes

No

Are you able to keep the foster animal(s) separate from your own pet(s)? *

Yes

No

If any personal pets become ill from being around the foster animal, the shelter cannot treat them. Please confirm your understanding. *

I understand.

Are you willing to bring the foster animal(s) into the shelter for checkups and regular vaccinations? *

Yes

No

Are you willing to administer medications should the foster animal(s) require them? *

Yes

No

How did you hear about our foster care program?

To become an LHS foster parent, I understand that I will be required to fully read the foster care manual. If I meet the requirements of the program, I agree to fulfill the duties and responsibilities of an LHS foster parent outlined and to abide by the policies an procedures of the foster care program. *

Please type your full name as a digital signature.

Foster Care Application

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