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Apply to become a foster home

Thank you for your interest in becoming a possible foster home for animals!

Please take a few moments to complete the form below.

Someone will review your application and get back to you as soon as possible. 

* Required

 

 

 

Personal information
Full Name: *
Address:
City:
State:
Zip Code:
At least ONE phone number required:
Home Phone:
Cell Phone:
Work Phone:
What is the best time to reach you?
Can you receive
calls at work?:
 Yes
No
Email Address:* (we do not share your info or sell it with/to any 3rd parties)
 

Household information
NOTE: MHS Requires All Household members to have an up-to-date tetanous shot
People in household (including yourself):
NAME RELATIONSHIP
AGE
ALLERGIC?
 IF OTHER ALLERGY, SPECIFY
Pets in household:
NAME SPECIES BREED AGE/HEALTH
INDOOR/OUTDOOR
SPAYED/NEUTERED?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
If you have cats, have they been FeLV/FIV tested?
Yes No
If yes, were the results of these tests negative?
Yes No
Are your animals current on their vaccinations?
Yes No
Current vet:
Vet's phone number:

Living Situation
Do you own or rent?
Own Rent
Building you live in is a...
If renting,
Landlord's name:
Phone number:

(incl. area code)
Do you have a room in which the foster pet(s)
can be separated from your other pets?		 Yes No
Have you been or are you currently involved with
another rescue group or humane organization?		 Yes No
<-- If yes specify
Would you allow potential adopters to come to your home to see the animal? Yes No
If no, would you be willing to bring the animal to another location for the potential adopter to see animal? Yes No

Foster Information
SPECIES AND NUMBER OF ANIMAL(S) WILLING TO FOSTER
Specify, if 'Other' How many

Dogs ONLY:
Specify size & type of dog(s) able to care for      

Fenced yard area is available for foster dog(s)       Yes No

Please specify the type of fencing being used      
Length of time you are able to foster
Anytime during year you are unable to foster
Hours per day animal will be left alone
Able to foster a sick or injured animal?
 Yes No
If yes, are you willing to bring the animal to a vet?
Yes No
Comfortable giving meds to sick or injured animal?
(check any that apply)
Pills Shots None
Supplies/Assistance Needed:
TYPE
CAN PROVIDE / NEED PROVIDED
Food
Litter
Medical Care
Bowls/Feeding Utensils
Leashes/Collars
Carriers

References
Please list the name, address, and phone number of three individuals as references. The
Minnesota Humane Society will contact these references.
1) Name
Address
Phone
 (+ area code)
2) Name
Address
Phone
 (+ area code)
3) Name
Address
Phone
 (+ area code)

Comments:
           
AGREEMENT
Check box -->

* By checking this box, I agree and understand that I shall be legally responsible for any animal(s) that I foster for the Minnesota Humane Society.

 

                                         

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