Dog Foster Application - Humane Society of Burnett County

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Full legal name and age of each household resident over the age of 18:*

Ages of children (under 18) living in the home:*

Who will be the primary caregiver?

Email*

Home Phone

Cell number*

Date of Birth*

Height of fence if applicable

Do you live in a (circle): HOUSE APARTMENT DUPLEX TOWNHOUSE OTHER

If no fence, describe plans for containment:

How long have you lived at this address:*

Landlord name and phone number or email

Describe any major events/life changes occurring in the next 6 months:

How long are you able or willing to foster?*

It may take patience and time for your new foster pet to feel comfortable in your home; how do you plan to ease their transition:*

Where will your foster pet be housed?*

How often/how long will your foster pet be left alone without humans?*

Where will your foster pet be kept when alone?*

Employer

Employer Phone Number

Describe work schedule/hours and flexibility to allow for vet visits, meet & greets with potential adopters, etc:*

Current Animals

Enter the Sex, Cat / Dog, Breed, Spayed/Neutered, UTD Vaccinations on each line

If any pets are not current on vaccinations or unaltered, please explain reasoning:

Name of vet clinic you use

Vet Phone Number

Do you have a separate space to keep foster animal away from pets if necessary? Describe:

What is your dog experience level*

Breed(s):

Previous dog foster Name of rescue/organization

Any other situations you feel unprepared or unwilling to handle?

Is there anything else you’d like to share?

HSBC determines the criteria for fostering, decides which animals are eligible for foster care, and which applicant is suitable for any given animal.
• HSBC foster care staff may always refuse any specific request for any reason.
• HSBC staff will inform you of any medical treatments to be administered, the anticipated, length of the foster-care period, the objectives of each particular placement (restoring to health, rearing to adoptable age, socialization, etc.), and any other restrictions or expectations we may have.
• You will be expected to keep the animal safe and secure, return it to HSBC when requested to do so, and not promise the animal to anyone, or imply that you have the authority to approve a potential adoption.
• HSBC retains ownership of all animals placed in foster care, and will make all decisions regarding the adoption & placement of the animals fostered.
• Fosters will be required to fill out an adoption application if they wish to adopt.
• Unless otherwise arranged, the foster parent is responsible for providing all food, bedding, and toys for the animal while it is in their care at home.
• HSBC will provide all medical care; any medical concerns should be brought to the attention of the Foster Coordinator and will need prior approval for vet appointments. The foster parent is responsible for transporting the animals to and from veterinary appointments, surgery, vaccinations, meet & greets with potential adopters, etc.
• I have read and understand the statements above. I certify that all the information contained in this application is true and correct.
• I understand that although HSBC takes reasonable care to screen animals for foster care placement, it makes no guarantees relating to the animals ’health, behavior or actions.
• I understand that I receive foster care animals at my own risk and can decline to accept any animal for which HSBC has asked me to provide care.
• I acknowledge that HSBC is not responsible for any property damage or personal injury suffered by me, members of my household, including my own animals, or any third parties during a foster placement, and I assume liability to provide adequate controls to prevent such damage or injury.

E-Signature

Date