Special Needs Pets - Española Humane

Name*

First Last

Email*

Date of Birth*

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Work Phone

HOUSEHOLD

How long have you lived at present address?*

Do you own or rent your home?*

How many adults in the household?*

How many children in household?*

Names and ages of Children?

Who will be responsible for foster animals' care?*

PETS

Do you have now or have you had pets in the past?

If so, Types of Pets?

Are the pets in your household spayed or neutered?

Are they vaccinated?

Length of time during the day animals would be left alone?*

Where will you keep the pets during the day?

Where will you keep the pets during the night?

For how long are you interested in fostering?*

Are you able to transport animals between your home and the shelter?*

Foster Care*

When in foster care, if I find someone wanting to adopt, the shelter must be notified immediately and all potential adopters must complete adoption applications.
When in foster care, it is possible that animals may develop an illness that would require that I transport them immediately to the shelter where they may be treated or euthanized at the discretion of the shelter veterinarian.

The purpose of this questionnaire is NOT to quiz you on your capabilities as a dog owner, but to find out what kind of animals you are willing to foster, how often you are willing to foster, etc., so that we can find the best possible matches between dogs and their foster parents. Answering "no" to a question does not necessarily preclude you as a foster parent; it just influences your pairing.

What type of pets would you like to foster? (select all that apply)

Adult dogs (healthy)
Adult dogs (ill/injured)
Puppies
Kittens
Adult Cats(healthy)
Adult Cats(ill/ injured)

If you would like to foster puppies or kittens, would you consider "bottle-feeders?"

What size of dogs would you like to foster?

Small
Medium
Large
Any

Are there any breeds that you are particularly interested in?

Are there any breeds that you would like to avoid?

Do you have a yard with a fence that a dog can be contained in?

If yes, how tall is the fence and what kind is it?

The Española Valley Humane Society does not believe in chaining dogs or letting them roam (i.e., outside without a fence). Is this a problem?

Are you willing to take a dog who is hyper, jumps, chews or needs training?

Most dogs and puppies are not housebroken. Will this be a problem?

Would you be interested in fostering a nursing mother cat or dog?

If so, with how many puppies or kittens?

Are you interested in fostering puppies or kittens with Ringworm? Ringworm is a potentially contagious, but non-life-threatening disease that is very common in shelter animals.

Have you had a dog with parvovirus or distemper in your home or yard in the past year?

If yes, what happened to them?

The information supplied on this application is true to the best of my knowledge.

I Agree

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HOUSEHOLD

PETS