WAYNE COUNTY HUMANE SOCIETY
Foster Care Application
Today’s Date: __________________________________________________________
Name: ________________________________________________________________
Address: ______________________________________________________________
City, State, Zip: _________________________________________________________
Phone: _______________________________________________________________
Email: ________________________________________________________________
Foster Home Information
Name Age How will they be involved in care?
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Animal Name Age Breed Sex Rabies Date
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Name of Vet Clinic & Phone #: _____________________________________________
In order to be approved to foster for WCHS, all animals in your home must be vaccinated against rabies.
Please consult your veterinarian about fostering. They may recommend additional vaccinations to protect your pets.
If needed, do you have to have approval to have a foster pet in your home? ____Yes ____No
Describe where you will be keeping the foster animal(s), including how you will separate them from your own animals, if applicable:
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Approximately how long, on an average, will foster animal(s) be left alone in the home (without people to monitor eating, behavior and bathroom activities)?
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Previous experience with animals:
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My household is able to foster : (check all that apply)
Cats/Kittens Dogs/Puppies
Pregnant cat Pregnant dog
Nursing Mother & Litter Nursing Mother & litter
Kittens 0-4 weeks of age Puppies 0-4 weeks of age
Kittens 4-10 weeks of age Puppies 4-10 weeks of age
Adult cat Adult dog
Recovering from injury/surgery Recovering from injury/surgery
On treatment for a cold On treatment for cold
On treatment for ringworm On treatment for ringworm
Needs behavioral/manners modification Needs behavioral/manners modification
Anything else you would like to share about yourself or your experience?
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