Henry County Humane Society - Geneseo

Foster Care Application

What type of animal(s) are you interested in fostering?

Orphaned Kittens
Pregnant Cat
Adult Cat

Orphaned Puppies
Pregnant Dog
Adult Dog

1. Are you a part of any animal organization? Yes No If yes, which one?
   
2. Why would you like to foster?
   
   
3. Do you live in a: Condo/Townhouse Apartment Duplex Mobile Home House
   
   
4. Do you: Own Rent/Lease
   If you rent, is your lease: Yearly Monthly
   Name of complex and/or association:
   Name and phone number of landlord or owner:
   Pet policy:
   How long have you been at this address?
   
   
   
   
5. How many adults reside at this address?
   
   Are there children in your home? Yes No
   If yes, how many and what are their ages?
   
   
   
6. Would there be anyone at home during the day? Yes No
   If yes, who?
   
   
   
7. Do you have any dogs and/or cats at home now? Yes No
   
   Name Age Breed Sex Licenced
   
   Male Female Yes No
   
   Male Female Yes No
   
   Male Female Yes No
   
   
   Approximate date and reason of last vet visit
   
   
8. Have you had other pets in the past 5 years? Yes No
   
   Name Age Breed Sex Disposition
   
   Male Female
   
   Male Female
   
   
9. What animal hospital/clinic do you (or did you) use?
   
   
10. Where will the foster animal(s) be when no one is home? Indoors Outdoors
    
    
11. Where will the foster animal(s) sleep? Indoors Outdoors
    
    

I, , agree that all of the information which I have given above is correct as written and I authorize the Henry County Humane Society - Geneseo to verify any information.

Date:

Volunteer Signature:
(By entering your name, you are signing this agreement)