Foster Application

We are committed to finding permanent responsible, and loving homes for our animals.

Thank you for your interest in providing foster care for a homeless animal. Foster parents provide the love and attention these animals need, and Henrico Humane Society provides food, support and medical care.

Please complete all fields on this application and print it before clicking “submit”. A foster care coordinator will get in touch with you after contacting the references you provided, including your previous or current veterinarian, landlord and personal references. Your patience while our dedicated volunteers process your application is greatly appreciated.

First Name:
MI:
Last Name:
Street:
City:	State:	Zip:
Home Phone:
Work Phone:
Cell phone:
Employer:
Email:

What is your age?

Is there a specific animal you would like to foster?
Yes No

If so, please describe the animal:

Who will be the primary caregiver of the animal?

Why is this a good time to foster an animal?

Marital Status:
Single Married Separated Divorced Widowed

Number of adults in your home:
Number of children and ages:

Are all adults in your home aware of and agreeable to fostering a pet?
Yes No

Does anyone in your home have asthma or pet allergies?
Yes No

Do you anticipate any major lifestyle changes (moving/marriage/new baby)?
Yes No

If yes, please explain:

Will your foster be left alone for 4 or more hours during the day(or night)?
Yes No # Hrs:

Where will your foster stay when it is left alone?

Have you had pet(s) before that are no longer with you ?
Yes No

What kind of pet?
How many?

What happened to that/those pets ?

Have you previously fostered an animal through a humane society or animal shelter ?
Yes No

Type of animal:

Adoption Date:

Name Of Shelter:

Are you able to bring your foster to adoption stand approximately twice a month?
Yes No

Have you ever returned or surrendered a pet
through a humane society or animal shelter ?
Yes No

Type of Pet:

Surrender Date:

Name Of Shelter:

Reason for Surrender:

Have you ever been reported to animal control
or had an animal removed from your care ?
Yes No

If yes, when did this happen?

Please explain the circumstances and the outcome:

Do you have other pet(s) now ? Yes No If yes, please tell us about them:

Type of Pet	Pet's name	Age	Sex	Spayed / Neutered	Last shots (Date)	How long have you had this pet ?	Where does this pet stay? (Indoors only. In/out, Outside only.)
				Yes No
				Yes No
				Yes No
				Yes No

What type of foster are you imterested in?
Dog Puppy Cat Kitten

Any particular color or breed/mixes?

What characteristics are you looking for in a foster?

Playful	Easygoing	Companion
Good with kids	Housebroken	Crate-trained
Litter box trained	Good with dogs	Obedient
Guard dog	Lap cat	Good with cats
Energetic	Outdoor dog	Previously declawed
Likes to run	Indoor/lap dog

Other characteristics:

What behaviors would you find unacceptable in your foster?

How would you handle behavior problems in your foster?

Who is your current or previous veterinarian?

Phone number:

I would like additional information on:

Spay/Neuter	Flea control	Feline leukemia	Vaccinations
Heartworms	FIV(feline AIDS)	Nutrition	FIP(feline infectious peritonitis)
Behavior/Training	Parvo	Declaw Alternatives

Local ordinances pertaining to pet licensing, rabies vaccinations, and leash laws.

Other:

Do you  Own   or    Rent   your home?

If renting, give name and phone number of landlord:

Do you have a yard?   Yes    No       Is it fenced? Yes    No

What type of fence?    Fence Height:

Does your lease allow pets?
Yes No Don't Know

Does your lease limit the number of pets living in your home?
Yes No Don't Know

Does your lease limit the size(weight) of the pets living in your home?
Yes No Don't Know

What is the size limit?
What is the maximum number of pets allowed by your lease?

REFERENCES: (Please list someone outside your home):

Name	Phone Number	Relationship to you

* * * * * * Henrico Humane Society Pet Adoption Application * * * * * *

I understand that I will be fostering the pet that I agree to take into my home. I understand that adoption is process. I understand that HHS is responsible for placing the foster in an appropriate home. HHS has experienced adoption screeners who will match the foster with an applicant at their discretion. I am not permitted to give the foster dog to an interested 3rd party or allow the foster dog to leave my care to an interested 3rd party without a completed and approved application. The application must be approved by an HHS adoption screener.

In the event that my foster dog escapes my custody I am to contact HHS immediately in order to help locate the lost foster.

In the event that I am unable to continue to care for my foster pet I understand that HHS needs time to find and appropriate replacement foster home. HHS may require up to 2 weeks in order find a suitable replacement foster home.

By signing below, I certify that all the above information is true and I recognize that any
misrepresentation of facts may result in loss of my adoption privileges.

I authorize verification of all statements in this application with the listed veterinarian, references and landlord.

Henrico Humane Society reserves the right to refuse an adoption to anyone who, in its opinion, will not provide a suitable home for this pet.

_________________________________________________	________________
To be signed in the presence of an HHS representative	Date

Driver's License #: ______________________________

Interviewed by: (HHS Adoptions Counselor): ______________________________

For HHS Adoptions Counselor Use:

RE: HHS animal ID #: ____________________________________

Pet's Name: ____________________________________________

Interview Date: __________________________________________

Interviewed by: __________________________________________

Adoption Stand Location: __________________________________

Recommendations:

Outcome:

Please print these pages BEFORE you click on the Send Application button below and bring
the form (unsigned) with you when you meet with the HHS representative
that contacts you about the adoption process.

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