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Home
Bark Parks
Beagles!
About
Adoptable Animals
Donate-Membership
Donations
In Honor Of
In Memorial Of
Membership
Other Ways To Give
Volunteer
Thrift Shop
Events & Fundraisers
Community Outreach
Articles & Newsletters
Behavior Issues
Lost & Found
Pet Medical Help
Spay/Neuter
Surrender
Foster Home Care Volunteer Application
Please note: For the benefit of the animals, we'll continue to call other volunteers if we are not able to contact you right away.
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Indicates required field
Foster Home Care Volunteer: Name
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First
Last
Date
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Daytime Phone No.
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Email
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Please identify all dogs/cats/other pets currently living in your home
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Include Breed/Name/Age/Sex/Spayed/Neutered.
If you currently own animals, please list your veterinary reference where vaccination records can be found, veterinary phone number, and whose name they are under.
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Does your veterinarian know you plan to become a foster parent?
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If not, we suggest that you inform your veterinarian.
Household Information
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Own Home
Apartment
Condo
Farm
Other
If you rent, provide landlord's contact info, including phone number and/or email address.
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Are all of your animals current on their vaccinations?
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Yes
No
If yes, please attain copies of current vaccination records and fax them to us at 715/634-5394 (or have your veterinarian fax them directly) to the attention of the Foster Home Coordinator.
If no, please provide estimated date of when vaccinations will be current and forward at that time.
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Required Vaccinations:
ALL animals
in the home must be vaccinated for Rabies and Distemper. Recommended vaccinations include:
Bordatella vaccinations are highly recommended for all dogs in the home
Feline Leukemia vaccinations are highly recommended for all cats in the home.
Does anyone in the household have pet allergies?
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Yes
No
How many children live in or visit your home
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Include their ages
If yes, are allergies controlled?
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How many hours/day would animals be alone?
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Do you travel frequently?
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List any members of the family that may assist in caring for the animals.
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Please list names (first and last) of all people living in your household.
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Do you have a room to isolate foster animals from other pets? If yes, please describe the area & how you would isolate them.
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Describe your experience in caring for sick or injured animals. Please note any experience you have in dog obedience training or behavior medication.
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I would be willing to offer a foster home for the following canine placements:
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Single Puppy
Litter of Puppies
Mom with Puppies
Adult Dog
Large Breeds
Small Breeds
Minor Illness
Active, in need of manners
Injured/Recovering from Surgery
Not House-Trained
Need Socialization
May Exhibit Separation Anxiety
Food Possessiveness
Not Applicable
I would be willing to offer a foster home for the following feline placements:
*
Single Kitten
Small Litter
Litter Any Size
Mom with Kittens
Injured/Recovering From Surgery
Adult Cat
Not Litter-Trained
Upper Respiratory Infections
Needs Socialization
Not Applicable
The best time for our family to schedule a NHS Foster Home Visit would be:
*
Please include date(s), morning, afternoon, evening, etc.
What motivation do you have in wanting to foster animals?
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In consideration of NHS accepting or denying my application for participation in the foster Home program, I agree to release and hold NHS harmless from and against any and all loss, damage, claims, liability, costs and expenses, of any nature whatsoever, including without limitation attorney's fees and disbursements. I further agree to indemnify NHS for any of the foregoing asserted by third party, including but not limited to, other individuals residing at my home, to the extent that any of the foregoing arise from or are occasioned by my participation in the foster home program. I understand that when I care for NHS animals in my home, I am doing so strictly as a volunteer and in the spirit of volunteerism. Thus, I will not expect to make claim for wages in return for my services. I agree that NHS may photograph my participation in this program, and I hereby release any such photographs to NHS for use in its programs, publications, and purposes.
By typing my name and date in the boxes below, I acknowledge I am providing accurate information to NHS.
PARENT/GUARDIAN SIGNATURE
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DATE
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Submit