Foster Care Application Fill out below We will get in touch with you! Number of animals I can foster.I have a preference for specific animals.YesNoI would like to foster Shelter-rescued animals.YesNoI agree that all statements in this application are made based on personal knowledge and are made for purposes of my application to foster one or more animals through YOUR Humane Society SPCA (hereafter "Shelter") Foster Care Program.If yes, List Name(s)or ID#'s:If any of the animals I specified are unavailable, I am open to substitution.YesNoAny Restrictions on the type of animal(s) you can foster? For Example: No dogs over 30 lbs, Only adult cats, etc.Where my foster animal(s) will sleep at night.Where my foster animal(s) will stay during the day when I AM home.Where my foster animal(s) will stay during the day when I AM NOT home.I understand that the Shelter is very concerned about the security and safety of my foster animal(s) and all the animals in its custody, as well as its ability to keep track of all animals rescued. I understand the Shelter will not share the information for any reasons not connected to the Foster Care Program or applicable lawsuits.Name *FirstLastAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHome PhoneCell PhoneWork PhoneEmail *Email will be the primary method of communication from the Shelter, so if you do not check email regularly, please let us know how best to contact you.Driver's License NumberState of IssueName, address and telephone number of my employer (of business, if self-employed)Business NameAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhonePositionI own my own home and am permitted to bring an animal or animals into my dwelling.YesNoI rent my home and am permitted to bring an animal or animals into my dwelling.YesNoProperty Owner's Name *FirstLastAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneLength of time at this residence.I have a fenced yard. (For dog foster only)YesNoNot applicableI currently have companion animals at my home.YesNoMy current companion animals are up to date on all vaccines.YesNoNot applicableMy current companion animals are sterilized.YesNoNot applicableMy current Veternarain isPhoneList all of the people living in the home and/or who have regular contact with your animals and their relationship to you. (Include family, friends, domestic employees, etc.)List two references (non-related)1) NameRelationshipPhone2) NameRelationshipPhoneI understand a Shelter Representative may visit my home for a home inspection before my foster application is approved.I have read this Application in its entirety, and I agree that all statements contained in this document are made by me and are truthful. I make this statement under penalty of perjury under the laws of the state of Florida. Electronic signature: (Enter Full Name to Sign) *FirstLastDatePhoneSubmit
