Foster Application for New Kent Humane Society, Virignia

Please complete all the questions completely and to the best of your knowledge.

Primary Email*
Secondary Email*
SIZE(s) and BREED(s) OF DOG OR CAT that interest you:*
Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Home Phone*
Work Phone
Cell Phone*
Emergency Contact*
First Last
Emergency Contact Relationship*
Emergency Contact Phone Number*
How did you hear about us?*

(adopted a New Kent Humane Society pet, visited us at an adoption outing, referred by a friend, saw a business card or flier, found us online, read an article about us in the paper, etc.)
Are you over 21?*
- Yes
- No
Occupation*
Employer*
Employer Address*
Street Address City State ZIP Code
Total Adult in Household*
Ages of Children
Number of Children*
Is this the first foster pet for you and/or your family?*
- Yes
- No
Are all the adults in your household aware that you are fostering a dog/puppy/cat/kitten?*
- Yes
- No
Who will be the primary caregiver for your foster pet?*
Does any member of your household have an allergy to dog/cat hair/dander?*
- Yes
- No
What do you hope that a foster pet will add to your lifestyle?*
Please select the temperament and activity level you are seeking in a dog (select all that apply):*
- Athletic/High Energy
- Mellow
- Quiet
- Very Affectionate
- Lap-dog
Have you ever worked with a shy dog before?*
- Yes
- No
What type of housing do you live in?*

(detached, town house, apartment, etc.)
Do you own or rent?*
- Own
- Rent
If renting, what is your Landlord's policy on pets?
If renting, Landlord's name
If renting, Landlord's Phone
Do you have a completely fenced yard?*
- Yes
- No
If yes, what is the type and height of the fence?
Is there a gate?
- Yes
- No
Is there a pool?*
- Yes
- No
If yes, is there a fence around Pool?
- Yes
- No
How many hours each day will the foster animal be left alone?*
Where will the foster pet be kept when alone?*
Will the foster pet be crated?*
- Yes
- No
In what room will the foster be kept?*
Where will the foster pet be kept during the day when you are home?*
Where will the foster pet sleep at night?*
What type of exercise will you give your foster pet?*
How often?*
Are there times when the foster dog will be tied outside, or cat be put outside?*
- Yes
- No
If yes, when?
If you presently have other animal(s), please describe:*
Please list for each animal: Name, Age, Spay/Neutered, Breed, Gender
If you presently have other animal (s), Are your animals current vaccinations?
- Yes
- No
Pet's veterinarian name*
Veterinarian City/town:*
Veterinarian phone number*
Personal Reference of someone not living in your home*
First Last
Phone*
Personal Reference of someone not living in your home*
First Last
Phone*
Have you ever turned a pet into a shelter?*
- Yes
- No
If yes, explain:
What methods will you use to train your foster pet?*
If your foster pet has an accident in the house, how will you correct him/her?*
How long do you expect housetraining to take?*
Do you agree to keep your foster dog on heartworm preventative year round?*
- Yes
- No
When you go on vacation/travel, who will care for the foster dog?*
If you move, what will you do with the foster dog?*
Have you previously applied to adopt a dog or cat from a rescue or shelter?*
- Yes
- No
If Yes, When?
What was the result of your application?
Have you ever relinquished or returned a dog or cat to rescue or shelter?*
- Yes
- No
If yes, when and why?
Are you willing to have a New Kent Humane Society representative visit where the foster will be living?*
- Yes
- No
PLEASE SIGN & REVIEW
Please read and initial the following information required by VA law for all volunteers of rescue organizations. You must sign this before volunteering in any capacity. Please note:Your initials represent your signature.

1. RELEASE

I, the undersigned volunteer understand and agree that a possibility of injury may occur while working with animals. I, the undersigned volunteer (or parent or guardian), desiring to donate my time and talents to New Kent Humane Society hereby release New Kent Humane Society from any loss or injury that may result from my volunteer activities.

2. POLICIES & PROCEDURES

I, the undersigned volunteer or parent or guardian (if volunteer under 18) agree to review, understand, and support all New Kent Humane Society policies and procedures.

3. STATEMENT REQUIRED BY VIRGINIA LAW [Code § 3.2-6546] A Virginia law went into effect on July 1, 2003 requiring all “home-based rescues,” which would include its definition, to obtain signed statements from anyone adopting from, volunteering with, or connected to us in any capacity that the individual “has never been convicted of animal neglect, abandonment, or cruelty.”

I, the applicant on this form and undersigned volunteer or parent or guardian (if volunteer under 18), am connected with a home-based rescue as defined under Virginia law, specifically New Kent Humane Society, as a volunteer, foster care provider, and/or adopter. With my signature below, I attest that I have never been convicted of animal neglect, abandonment, or cruelty.
I have read the above Release, Polivies & Procedures, and STATEMENT REQUIRED BY VIRGINIA LAW [Code § 3.2-6546]*

You must sign this before volunteering in any capacity. Please note: Your initials represent your signature.

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