Foster Care Application

Foster Animal Name:*

Current Date:*

Date Due Back To Shelter:*

Foster First and Last Name:*

Address:*

Street Address Address Line 2 City State ZIP Code

Daytime Telephone Number:*

Evening Telephone Number:*

Email Address

Are there children in the home?

Ages of children in the home:

Name of Veterinary Clinic:*

Number of hours alone daily:*

Outdoor containment (i.e. fence, tie-out, etc.):*

Number of Dogs in your Household:*

Breed of Dogs in your Household:*

Age of Dogs in your Household:*

Number of Cats in your Household:*

Are Your Dogs Spayed/Neutered?*

Are Your Cats Spayed/Neutered?*

Are Your Dogs Up-to-Date on Bordetella Vaccine?*

Yes
No

Are Your Dogs Up-to-Date on Parvo Vaccine?*

Yes
No

Are Your Dogs Up-to-Date on Distemper Vaccine?*

Yes
No

Are Your Cats Up-to-Date on Distemper Vaccine?*

Yes
No

Are Your Cats Up-to-Date on Feline Leukemia Vaccine?*

Yes
No

FDHS To Complete This Section

Foster Weight:

Foster Breed:

Foster Sex:

Pregnant:

Yes
No

Neutered/Spayed:

Yes
No

Foster Signature (by signing below you are agreeing to the terms and conditions noted)*

I am over 18 years of age and hereby undertake with the said society as follows to: 1. I hereby acknowledge receiving the above described animal from the Fort Defiance Humane Society. 2. I agree to provide proper food, water, safe living conditions, and kind treatment at all times. 3. I agree that if I am fostering a cat, it will be an indoor pet and will not be allowed outside at any time. 4. I agree that if I am fostering a dog, it will live in my home as a family member and will not be put outside to live at any time. 5. I agree to license the animal in compliance with the laws and ordinances in force in the municipality in which I reside if I am going to foster for more than 30 days unless otherwise verified through staff. 6. I agree to return the foster animal to the Fort Defiance Humane Society if at any time I can no longer keep the animal. 7. I agree not to allow the animal to be used for medical or other experimental purposes. 8. I understand that the Fort Defiance Humane Society does NOT refund fees for food and/or care. 9. I understand that the Fort Defiance Humane Society cannot guarantee the health, temperament, or training of the above described animal and hereby agree to release the Fort Defiance Humane Society from all liability once the animal is in my possession. I also understand that I cannot hold Fort Defiance Humane Society responsible for any incident (biting, nipping, destruction of property, etc.). 10. It is agreed that the Fort Defiance Humane Society retains superior title in said animal limited to and for the express purpose of assuring the animal’s well-being and will exercise its superior claim in the event it appears to the Fort Defiance Humane Society that the proper and humane care as specified in the foster agreement is not being afforded this animal. 11. I understand that if this is a foster to adopt, I have 7 days to bring the animal back to Fort Defiance Humane Society or complete the adoption process. I understand that if I am fostering special needs I have up to 14 days to decide if I would like to adopt said animal.

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(419) 658-2298

Your donations provide care for homeless pets.

Are You Interested in Fostering?