Riley County Humane Society, Inc.

P.O. Box 1202

Manhattan, Kansas 66505-1202

(785) 776-8433

Please print, complete, and mail to the address above. Or, give it to the RCHS volunteer you have been working with.

Foster Care Application

Date: ___________

Name: _______________________

Address: ______________________________________________________

Daytime Phone: _______________ Evening Phone: ________________

E-mail: ________________________ Date of Birth: _________________

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I am willing to foster the following (please circle)

Cat with Kittens Dog with Puppies Horse

Kittens Puppies Other:_________

Sick Cat/Kitten Sick Dog/Puppy

Adult Cat Adult Dog

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Do you or have you ever owned a pet? Yes No

What type and how many animals do you currently have in your home? ____________________________

______________________________________________________________________________________

Are animals currently in your home spayed or neutered? Yes No

Who is your local vet (we may call your vet as a reference)? _____________________________________

Do you own or rent your home? Own Rent

If you rent, who is your landlord? _________________ LL=s phone#: _______________

Please describe the general area where the animal(s) you are fostering will be kept: ________________________________________________________________

________________________________________________________________

Do you have children and, if so, what are their ages? ____________________________________________

Have you ever fostered animals before (this applies to any organization)? Yes No

Would you be willing to foster exotic animals? Yes No

If yes, what type of exotic animals do you have experience with? _________________________________

Are you willing to allow RCHS to visit the animal(s) at your home? Yes No

For example, in order the take a digital picture for the PetFinder.Com website.

Are you willing to abide by all animal control laws with regard to your foster animals? Yes No

Frequently, we try to have animals adopted directly from a foster home:

Can a prospective adopter call you regarding your foster animal? Yes No

Can they visit your home to see the animal? Yes No

References:

1. Name/Phone: _____________________________________________________

2. Name/Phone: _____________________________________________________

3. Name/Phone: _____________________________________________________

As a foster parent, you will be required to keep your foster dog(s) on a leash or enclosed (within a fence adequate for the animal or in a home) at all times. Foster Cats must be kept indoors at all times. By initialing below, you acknowledge that you will abide by these provisions. Initial: ___________

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Foster parents must be a member of the Riley County Humane Society (RCHS). A foster license may be obtained through the RCHS.

As a foster parent, you may have an animal in your care for a short period of time (1 week) or an extended period of time (as many as 3 months or more). This will frequently be determined when you receive an animal to be fostered. However, this amount of time is subject to change depending on the circumstances. If you know that will be on vacation during the period of time you are being asked to foster, you are obliged to inform RCHS as such. This will allow us to find the most suitable temporary accommodations for your animal.

RCHS will be responsible for any veterinary bills. As a foster parent, you will be responsible for advising RCHS of needed veterinary care. The RCHS will designate a veterinarian, where you must take the animal for needed medical attention.

All new foster parents are required to be counseled by the RCHS before an animal is brought into the home. Additionally, while you are caring for foster animals, we may call you from time to time to check on the animal’s progress and address any concerns you may have.

As a foster parent, you are required to submit a foster home report within 2 weeks of obtaining the animal. This form will be provided by RCHS. Future reports will be submitted on an as needed basis when the animal has experienced any significant changes.

As a foster parent, we want you to know that RCHS is here to answer any questions or concerns you may have about caring for an animal.

By signing this form, you agree to the above statements and certify that the answers given above are true:

Signature: _______________________________Date:________________

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Office Use Only:

A ______ D ______

Comments: ________________________________________________________________________