Foster Care Application Name * Date * Address Street * Apt # City * State * —Please choose an option—AlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyoming Zip Code * Home Phone Cell Phone * Work Phone Email * Birth Date * Employer Company Name * Job title * I prefer to be contacted * EmailPhone Have you fostered animals before? * —Please choose an option—YesNo What agencies have you fostered with? [cf7mls_step cf7mls_step-1 "Next" ""] What types of animals would you like to foster? Felines Mother with nursing young * NoPossiblyYes Number Limit Newborn kittens requiring bottle feeding * NoPossiblyYes Number Limit Young only, self-feeding * NoPossiblyYes Number Limit Injured/sick cat * NoPossiblyYes Number Limit Cat recovering from surgery * NoPossiblyYes Number Limit Under-socialized cat (lots of TLC) * NoPossiblyYes Number Limit Canines Mother with nursing young * NoPossiblyYes Number Limit Newborn puppies requiring bottle feeding * NoPossiblyYes Number Limit Young only, self-feeding * NoPossiblyYes Number Limit Injured/sick dog * NoPossiblyYes Number Limit Dog recovering from surgery * NoPossiblyYes Number Limit Under-socialized dog (lots of TLC) * NoPossiblyYes Number Limit Please list any limitations that apply to your particular situation, i.e. animal size, age, breed, sex, transportation problems, etc * What kind of animal-related experience do you have? * Are you familiar with positive reinforcement training and are you willing to use this method of training? * Do you have any experience training or working with animals that have behavior problems? * —Please choose an option—YesNo How long can you keep a foster animal(s) in your care? * Are you willing to administer medications, should your foster animal require them? * —Please choose an option—YesNo Do you have experience administering medication to animals? * —Please choose an option—YesNo [cf7mls_step cf7mls_step-2 "Back" "Next" "Step 2"] The Suffolk Humane Society will cover necessary medical expenses provided by an approved veterinarian only. If you choose your own veterinarian, we cannot be responsible for the expenses. Any care must be pre-approved by the Suffolk Humane Society. Do you agree to these conditions? * —Please choose an option—YesNo Your veterinarian’s name Veterinarian’s Address City State —Please choose an option—AlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyoming Zip Code Veterinarian’s Phone Number [cf7mls_step cf7mls_step-3 "Back" "Next" "Step 3"] Please provide the information below for any current pets you have Pet 1 Pet's Name Breed Sex —Please choose an option—MaleFemale Spay/Neutered? —Please choose an option—YesNo Age Pet 2 Pet's Name Breed Sex —Please choose an option—MaleFemale Spay/Neutered? —Please choose an option—YesNo Age Pet 3 Pet's Name Breed Sex —Please choose an option—MaleFemale Spay/Neutered? —Please choose an option—YesNo Age Pet 4 Pet's Name Breed Sex —Please choose an option—MaleFemale Spay/Neutered? —Please choose an option—YesNo Age Have you ever had a dog with parvovirus? * —Please choose an option—YesNo Please explain. [cf7mls_step cf7mls_step-4 "Back" "Next" "Step 4"] Type of housing * —Please choose an option—HouseMobile HomeApartmentDuplexCondo Do you own your home or rent? * —Please choose an option—OwnRent Name of apartment complex or landlord Landlord Phone Number Do you have a fenced-in backyard? * —Please choose an option—YesNo How many adults live in your home? * Do all of the adults wish to foster animals? * —Please choose an option—YesNo How many adults live in your home? * Do other children visit your home frequently? * —Please choose an option—YesNo Ages? Do you or anyone in your home have any known allergies to pets? * —Please choose an option—YesNo Please explain. [cf7mls_step cf7mls_step-5 "Back" "Next" "Step 5"] Who will be the primary caretaker of the foster animal? * What is your work schedule? * How many hours per day will you be away from the home? * In what areas of the home will the foster pet be allowed? * Will you be able to keep foster pets separate from your own animals, if necessary? * May an employee of Suffolk Humane Society complete an annual visit to your home at a mutually convenient time? * —Please choose an option—YesNo May potential adopters visit your foster animal at your home at a mutually convenient time? * —Please choose an option—YesNo Are you able to transport your foster animal(s) to and from the Suffolk Humane Society frequently, if needed? * —Please choose an option—YesNo Are you prepared to deal with an animal that may become ill or die? (Some kittens and puppies are taken from their mothers so young that they struggle to survive.) * —Please choose an option—YesNo Realizing that fostering is a short-term, temporary arrangement which makes you the link between a homeless animal and finding them a “forever” home, are you certain you will be able to remain emotionally separated and be able to part with foster animals when they are ready to go back to the shelter or be adopted? * —Please choose an option—YesNo Do you agree to release Suffolk Humane Society from any liability concerning any foster animal, including but not limited to any damage the foster animal may inflict upon persons or property? * —Please choose an option—YesNo [cf7mls_step cf7mls_step-6 "Back" "Next" "Step 6"] The Suffolk Humane Society provides: Medical care (vaccinations and de-worming for dogs). Foster parents must notify Suffolk Humane Society of any health issues as soon as possible. Carriers (if needed and when available). Foster Parent Responsibilities: Provide a safe, loving, temporary home.• Provide a safe indoor environment. Provide food, water, bowls, toys, blankets, litter, litter boxes, and other supplies. Provide socialization, training, exercise, and administer medication for foster animals. Periodically transport foster animals to Suffolk Humane Society for vaccinations, checkups, or other special care. Provide emergency accident or illness veterinary care. Foster parents must contact Suffolk Humane Society if an emergency arises. Understanding that animals are the sole property of Suffolk Humane Society. Foster parents do not have any authority regarding who eventually adopts their foster pet(s). You cannot promise animals to anyone (friends, family, neighbors, etc.). Foster parents will return animals to Suffolk Humane Society on the pre-specified date or at any time that Suffolk Humane Society requests them. If the animal(s) must be returned before the scheduled date and time, Foster parents will contact the Suffolk Humane Society at least 48 hours beforehand to make other arrangements for the animal(s). Report lost animals immediately to Suffolk Humane Society. Provide insight to the foster animal’s behavior for its file in order to disseminate accurate information to potential adopters. If foster parents wish to adopt their foster pet(s), they must adhere to all Suffolk Humane Society adoption policies and procedures and apply through the regular adoption process. Suffolk Humane Society is not responsible for any damage or injury cause by a foster animal while it is in the care of a Foster Care Volunteer. I certify that the foster care application information is correct to the best of my knowledge. I also agree to follow all the rules, regulations and policies of the Suffolk Humane Society. I certify that no person residing in the household has ever been convicted of animal cruelty, neglect, or abandonment. AgreeI agree to submit to a background check to ensure that I do not have any animal related convictions. Signature * Date * [cf7mls_step cf7mls_step-7 "Back" "Step 7"]
Name * Date * Address Street * Apt # City * State * —Please choose an option—AlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyoming Zip Code * Home Phone Cell Phone * Work Phone Email * Birth Date * Employer Company Name * Job title * I prefer to be contacted * EmailPhone Have you fostered animals before? * —Please choose an option—YesNo What agencies have you fostered with? [cf7mls_step cf7mls_step-1 "Next" ""] What types of animals would you like to foster? Felines Mother with nursing young * NoPossiblyYes Number Limit Newborn kittens requiring bottle feeding * NoPossiblyYes Number Limit Young only, self-feeding * NoPossiblyYes Number Limit Injured/sick cat * NoPossiblyYes Number Limit Cat recovering from surgery * NoPossiblyYes Number Limit Under-socialized cat (lots of TLC) * NoPossiblyYes Number Limit Canines Mother with nursing young * NoPossiblyYes Number Limit Newborn puppies requiring bottle feeding * NoPossiblyYes Number Limit Young only, self-feeding * NoPossiblyYes Number Limit Injured/sick dog * NoPossiblyYes Number Limit Dog recovering from surgery * NoPossiblyYes Number Limit Under-socialized dog (lots of TLC) * NoPossiblyYes Number Limit Please list any limitations that apply to your particular situation, i.e. animal size, age, breed, sex, transportation problems, etc * What kind of animal-related experience do you have? * Are you familiar with positive reinforcement training and are you willing to use this method of training? * Do you have any experience training or working with animals that have behavior problems? * —Please choose an option—YesNo How long can you keep a foster animal(s) in your care? * Are you willing to administer medications, should your foster animal require them? * —Please choose an option—YesNo Do you have experience administering medication to animals? * —Please choose an option—YesNo [cf7mls_step cf7mls_step-2 "Back" "Next" "Step 2"] The Suffolk Humane Society will cover necessary medical expenses provided by an approved veterinarian only. If you choose your own veterinarian, we cannot be responsible for the expenses. Any care must be pre-approved by the Suffolk Humane Society. Do you agree to these conditions? * —Please choose an option—YesNo Your veterinarian’s name Veterinarian’s Address City State —Please choose an option—AlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyoming Zip Code Veterinarian’s Phone Number [cf7mls_step cf7mls_step-3 "Back" "Next" "Step 3"] Please provide the information below for any current pets you have Pet 1 Pet's Name Breed Sex —Please choose an option—MaleFemale Spay/Neutered? —Please choose an option—YesNo Age Pet 2 Pet's Name Breed Sex —Please choose an option—MaleFemale Spay/Neutered? —Please choose an option—YesNo Age Pet 3 Pet's Name Breed Sex —Please choose an option—MaleFemale Spay/Neutered? —Please choose an option—YesNo Age Pet 4 Pet's Name Breed Sex —Please choose an option—MaleFemale Spay/Neutered? —Please choose an option—YesNo Age Have you ever had a dog with parvovirus? * —Please choose an option—YesNo Please explain. [cf7mls_step cf7mls_step-4 "Back" "Next" "Step 4"] Type of housing * —Please choose an option—HouseMobile HomeApartmentDuplexCondo Do you own your home or rent? * —Please choose an option—OwnRent Name of apartment complex or landlord Landlord Phone Number Do you have a fenced-in backyard? * —Please choose an option—YesNo How many adults live in your home? * Do all of the adults wish to foster animals? * —Please choose an option—YesNo How many adults live in your home? * Do other children visit your home frequently? * —Please choose an option—YesNo Ages? Do you or anyone in your home have any known allergies to pets? * —Please choose an option—YesNo Please explain. [cf7mls_step cf7mls_step-5 "Back" "Next" "Step 5"] Who will be the primary caretaker of the foster animal? * What is your work schedule? * How many hours per day will you be away from the home? * In what areas of the home will the foster pet be allowed? * Will you be able to keep foster pets separate from your own animals, if necessary? * May an employee of Suffolk Humane Society complete an annual visit to your home at a mutually convenient time? * —Please choose an option—YesNo May potential adopters visit your foster animal at your home at a mutually convenient time? * —Please choose an option—YesNo Are you able to transport your foster animal(s) to and from the Suffolk Humane Society frequently, if needed? * —Please choose an option—YesNo Are you prepared to deal with an animal that may become ill or die? (Some kittens and puppies are taken from their mothers so young that they struggle to survive.) * —Please choose an option—YesNo Realizing that fostering is a short-term, temporary arrangement which makes you the link between a homeless animal and finding them a “forever” home, are you certain you will be able to remain emotionally separated and be able to part with foster animals when they are ready to go back to the shelter or be adopted? * —Please choose an option—YesNo Do you agree to release Suffolk Humane Society from any liability concerning any foster animal, including but not limited to any damage the foster animal may inflict upon persons or property? * —Please choose an option—YesNo [cf7mls_step cf7mls_step-6 "Back" "Next" "Step 6"] The Suffolk Humane Society provides: Medical care (vaccinations and de-worming for dogs). Foster parents must notify Suffolk Humane Society of any health issues as soon as possible. Carriers (if needed and when available). Foster Parent Responsibilities: Provide a safe, loving, temporary home.• Provide a safe indoor environment. Provide food, water, bowls, toys, blankets, litter, litter boxes, and other supplies. Provide socialization, training, exercise, and administer medication for foster animals. Periodically transport foster animals to Suffolk Humane Society for vaccinations, checkups, or other special care. Provide emergency accident or illness veterinary care. Foster parents must contact Suffolk Humane Society if an emergency arises. Understanding that animals are the sole property of Suffolk Humane Society. Foster parents do not have any authority regarding who eventually adopts their foster pet(s). You cannot promise animals to anyone (friends, family, neighbors, etc.). Foster parents will return animals to Suffolk Humane Society on the pre-specified date or at any time that Suffolk Humane Society requests them. If the animal(s) must be returned before the scheduled date and time, Foster parents will contact the Suffolk Humane Society at least 48 hours beforehand to make other arrangements for the animal(s). Report lost animals immediately to Suffolk Humane Society. Provide insight to the foster animal’s behavior for its file in order to disseminate accurate information to potential adopters. If foster parents wish to adopt their foster pet(s), they must adhere to all Suffolk Humane Society adoption policies and procedures and apply through the regular adoption process. Suffolk Humane Society is not responsible for any damage or injury cause by a foster animal while it is in the care of a Foster Care Volunteer. I certify that the foster care application information is correct to the best of my knowledge. I also agree to follow all the rules, regulations and policies of the Suffolk Humane Society. I certify that no person residing in the household has ever been convicted of animal cruelty, neglect, or abandonment. AgreeI agree to submit to a background check to ensure that I do not have any animal related convictions. Signature * Date * [cf7mls_step cf7mls_step-7 "Back" "Step 7"]
