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Rutherford County Humane Society Foster Pet Parent Application

Please complete this application, print out a copy for yourself, then click on the Submit Form Button. We will get back to you ASAP.



Todays Date
Home Phone
Cell Phone
Email Address
Please Indicate all that apply: House Apartment/Condo Rent Own Other:
How long have you lived at this address?: How old are you?
Are you presently a volunteer for the Rutherford County Humane Society?
List all people who spend significant time in your home
that you could expect to have regular
contact with the foster animals:
Are any of these people pregnant or immune compromised?
Are any of these people allergic to animals? Yes No
If so describe
Are any of these people under the age of 12?
What kinds of animals are you willing to foster?
Adult Cats Mother Cats and Kittens, Animals on Medications,
Adult Dogs Mother Dogs and Puppies, Cruelty Case Animals,
Puppies Unsocialized/Shy Animals, Unweaned Bottle Fed Babies
Kittens Injured/Sick Animals? Please Specify
Have you had experience taking care of these animals? Yes No Please Describe
What pets are currently living with you in your home?
Please provide breed, age, sex, spayed or neutered, and any medical
Where are your animals during the day?
Where are your animals during the Night?
Where do you keep food and water dishes for your animals?
Do your cats have an area for food and litter boxes that would be inaccessible to dogs?
Do Your current Animals like each other?
Do they like other animals?
What days and hours are all of the human adults typically
gone from your house?

Do you have a regular schedule?
What do you do with your own pets when on vacation or out of town?
Do you have an area in your home where you can isolate foster animals? Yes No
Are you willing to keep foster dogs and/or puppies crated
and cats and kittens confined when nohuman adults are
home to supervise?
Do you understand that most dogs and pups will not be housebroken and kittens or cats under
stress may sometimes potty outside the litter box?
How will you handle this?
Do you have a fenced-in yard?
How will you exercise pups and dogs over 10 weeks of age?
Can you provide basic supplies (litter, litter boxes, treats, etc) for your foster animals?
Do you have experience administering medications to animals?
If yes, please explain.
Do you understand that medical appointments for evaluation or
treatment may be necessary? Would you be willing to take
the foster pet to this appointment?
Are your current animals up-to-date
on their vaccines?
Have they been neutered? If not, why?
What is your veterinarian's name?
What is the Veterinarian Clinic
What is the Veterinarian Clinic Phone Number?
List names, addresses, phone numbers & email addresses of 3 NON-RELATED personal references, whom you have known for at least 3 years, and who may be familiar with your pet ownership history:
Reference #1
Reference #2
Reference #3
Please tell us why you would like to foster a pet and what makes you qualified to do so.

Recognition of Risk and Release of Liability
As a volunteer for the Rutherford County Humane Society (RCHS) Foster Pet Parent Program, I assume
responsibility for all human or animal injuries, illnesses, behavior or psychological problems incurred while
the foster pet(s) is (are) in my home or under my care. I realize that there are risks involved in caring for
animals and I hold the Rutherford County Humane Society, harmless in any way for said problems to my pets,
myself, my family or guests, including damage to personal property.
I also recognize that I am to provide a temporary home to RCHS foster animals. The animals are the property
of RCHS, and I agree to return the animals to RCHS on the date requested.
I understand and agree to the following:
· I will bring in my foster pets for vaccinations, treatment or checkups as instructed by RCHS
medical staff or the volunteer coordinator of the foster pet program.
· There will be limited or no contact between the foster animals(s) and my own pets of the same
species. This is especially important during the first 14 days the foster animal(s) is (are) in my
· Because of financial constraints, the RCHS may only be able to provide limited medical care to
the foster animal(s).
· If I, my family and/or my guests become sick due to exposure to the foster animal(s), RCHS will
be unable to provide medical care.
· The foster animal(s) may get sick and be euthanized.
· I realize that rescued foster animal(s) may be returned to an owner if legal custody is not gained by
· Foster animals released for adoption will be placed in the normal adoption program. Any potential adopter must be
approved by the RCHS Adoption Department.

By signing this application, I attest to the fact that I am 21 years of age or older, and that the above information provided is correct,
to the best of my knowledge. RCHS and potential foster parent agree to accept typed in names
(electronic signatures acknowledging approval of this agreement, to be the equivalent of actual signatures of the parties.

After completing this application, please click on the 'submit form' button at the top of this form.