SCHERTZ HUMANE SOCIETY FOSTER CARE APPLICATION Foster Care for a rescue dog can last as long as 6 months-are you able to make that commitment? Yes No Explain________________________________________________________________________________ Name: _____________________________________________ Address: _________________________________________________________ City: _______________________________________ State: ________________ Zip: _____________ Evening Phone: ___________________________ Daytime Phone: ______________________________ E-mail Address: __________________________________ Number of adults in the household: Men _______ Ages _________ Women ______ Age___________ Number of children in the household: Boys _______ Ages ________________ Girls _______ Ages _______________ Type of Dwelling: House Apartment Trailer Condo/Town Duplex/Triple Other - explain: _____________________________________ Do you own or rent? own rent If you rent, do you have the landlord’s permission to keep a dog? yes no n/a Landlord's name and phone number: ________________________________________________________ Please List All Pets You Currently Own: Dogs:____________________________________________________________________________ Breed_____________________________________________________________________________ Ages _____________________________________________________________________ Male _____ or Female ______ Spayed or Neutered? ___________ Stay Indoors or Outdoors___________________________________________________________ Cats:_____________________________________________________________________________ Breed______________________________________________________Ages_______________________ Males _____or Females _________ Circle one - Spayed or Neutered? Stay Indoors or Outdoors________________________________________________________________ Are all pets current on shots? yes no If not, explain__________________________________________ If your pets are not spayed or neutered, why not? _____________________________________________ _____________________________________________________________________________________ Current Vet: Name: ____________________________________________________________________ Address: _____________________________________________________________________________ City _________________________________________ State __________________ Zip __________ Phone Number _________________________________ Can we contact current vet for reference? _______________________ Environment: Is everyone living in this dwelling aware that a foster pet is being brought into the household? _______ Do You free feed? feed once daily? feed twice daily? Other feeding method? If other, explain: ________________________________________________________ Will the foster pet be kept separately from your pets, or with them? Circle one separate with pets Where will foster pet stay during the day? _______________________________________________ How large is your yard (approx.)? _________________________________________ Is it securely fenced? yes no ________________________________________________ If yes, what kind and how tall? __________________________________________________ Do you have a pool? yes no If yes, is it securely fenced? yes no n/a If your yard is not fenced, how do you plan to insure that the foster pet, if a dog, receives adequate exercise? ______________________________________________________________________________________ Where will the foster pet sleep? ___________________________________________________________ What arrangements are you willing to make for your foster pet if you need to go away for a few days? _____________________________________________________________________________________ How many consecutive hours a day are you away from home for work, school etc.? ____________ Are you close enough to go home during the day, if fostering a dog, and gone for many hours? _______________________________________________________________________________ Do you object to an initial visit to your home prior to or during fostering a dog? _____________________ Are you able to transport foster dog to vet for appointments? ____________________________ Do you have experience with: (Circle which apply) housetraining crate training obedience training ”problem behavior” caring for sick animals heartworm treatment Please note any additional information/special skills you have that may assist us in finding the proper foster pet for you:_________________________________________________________________________ __________________________________________________________________________________ Why do you want to foster? _________________________________________________________________________________ __________________________________________________________________________________ Please list two references: Reference #1 name __________________________________street ________________________________________ city _______________________ state ____________ zip __________ phone ______________________ Relation: ____________________________________ Reference #2 name __________________________________ street ________________________________________ city _______________________ state ___________ zip ____________ phone _____________________ Relation: _____________________________________ Do you agree to return your foster animal to Schertz Humane Society care if you are requested to do so, and understand that all placements must be approved by Schertz Humane Society? Yes No Do you understand that particularly shelter animals, having been abandoned by their previous owners, come with a lot of “baggage” and may have separation anxiety, may need to re-learn how to behave in a house environment and to bond with you and your other pets? Yes No I, the undersigned, attest that, to the best of my knowledge, the above information is accurate and complete at the time of signing. I understand that falsely provided information can mean that my application will be terminated. Signature ________________________________________________________ Second Signature (if applicable) ________________________________________ Date _______________________________________ Thank you for taking the time to fill out this application and having the interest in fostering a needy animal!