Foster Application If you are human, leave this field blank. Congratulations on your decision to foster an animal companion. South Wood County Humane Society is happy you are considering an animal from our shelter. The goal of South Wood County Humane Society is to find permanent, loving and responsible homes for the animals in our care. We do not adopt on a first come served basis, do not hold animals for adoption and our goal is to match the best animal for your situation. South Wood County Humane Society’s Foster Home Program is designed to offer housing for animals in need on a temporary basis or as a pre-adoption tryout. Please complete the information below to help us place the correct animal(s) in your home. In order to be considered for the foster program, you must: Be 21 years of age or have a co-signer present at time of turning in application and adoption if approved. Have formal identification (ex. Drivers License) Current pets must be up to date on vaccinations. SWCHS will check with landlords for approval of pets in rental homes, apartments and mobile home parks. Parental permission must be granted if you live in their home at time of application. Foster Questions Please indicate what type(s) of animals you would be interested in fostering (check all that apply): * Canine Feline Other (small animal) Animal Name:Animal Name: A&D:A&D: Please indicate which animals you would be interested in fostering (check all that apply): * Pre-adoption try out Pregnant cat / dog (could be up to 18 weeks) Mom cat / dog & nursing babies (up to 12 weeks) Senior cat / dog Cat / dog medical issues Cat / dog due to over-population Cat / dog requiring socialization Name and Address Information Name: * Date of Birth: * Address: * City: * Township: * State: * AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip: * Home #: Work #: Cell #: Drivers License #: * Spouse/significant other: Email* Your email address may be added to SWCHS mailing lists. Financial/Employment Employer/Source of income: * Phone: * Employment Status: * Part Time Full Time For how long? Supervisor's Name: Home Environment How long are you gone during the day? * At night? * Do you live in a _____? * House Mobile Home Apartment Condo Duplex Farm Do you _____? * Rent Own Live with parents/relatives Landlord/Manager/Parent’s Name: Phone: Renters, have you consulted with your landlord yet about having a pet? Yes No Will be soon Have you ever been convicted of a crime other than a minor traffic violation or any animal related violations? * Yes No If yes, explain: Has anyone in the household in which the animal may live been convicted of an animal related crime? * Yes No If yes, explain: Do you or anyone else in your household have any allergies to animals? * Yes No Do you have children that will be in the household with this animal? * Yes No If yes, provide ages: Names of people, over the age of 18, who live in the household or who visit on a regular basis: Name Age Add Remove Specific animal requested How did you learn about this animal? SWCHS website Facebook Newspaper Word of mouth What about fostering interests you? * Where will you keep this animal primarily? * Indoors Outdoors Both Are there any behavior issues you would find difficult to work with? * If you previously owned pets in the last three years, but no longer have them please indicate why (check all that apply): Given to family member/another person Given to rescue/shelter Ran away Passed away Please list all CURRENT pets in the household: Name Breed Age (yr) M/F Male Female Altered? Yes No Owned (yr) Add Remove Current Animals Are your pets current on their vaccinations? Yes No Are your pets licensed? Yes No Name of veterinarian: Phone Have you ever attempted to foster from a shelter or rescue before? * Yes No If yes, which shelter/rescue? South Wood County Humane Society has the right to accept or deny this application for any reason. A completed application does not guarantee an approved application. I certify that I am at least 21 years of age and the information given is true. I authorize any and all verifications of statements made in the application. I recognize that any misrepresentation of facts may result in losing the privilege of adopting a pet. I understand I am responsible for the cost of basic care which includes food, housing and quality of life needs while fostering this animal. I also understand SWCHS has the right to do a follow up visit and take pictures showing proper shelter is being provided for any animal kept outside. If this animal becomes ill, injured, or lost, I will contact the SWCHS immediately. I also sign that I understand how the foster process works, agree to complete any spay/neuter requirements and pay fees involved with adoption if required. Upon approval of this application, a physical signature may be required. Submit
