Metro East Humane Society Foster Parent Application Requirements Volunteers for this program: 1. Must be at least 18 years old. 2. Must complete our attached application, and participate in an interview and training session. 3. Must agree to a home visit by our shelter staff. 4. Must provide requested medical information for all personal pets. 5. Must sign the foster agreement pertaining to the animal you are fostering. 6. Must provide in-home care for MEHS animals assigned under the foster program and return animals to MEHS on the date requested. 7. Must keep appropriate weight, medication and/or behavioral records on the foster animal while in you care, and present a profile of the animal to MEHS upon return to us. This program is an opportunity for you to: Give love and affection to an animal that is so young that yours will be the first safe human interactions for that animal and will give a lasting foundation for human interaction to that baby. Provide a safe environment for frightened or unsocialized animals that have not learned humans can be trusted. You can help them lean new behaviors and better ways to interact. Help MEHS maintain a disease free shelter by caring for at-risk or sick animals until it is safe for them to return to the shelter. Help MEHS save more animals by freeing up space in shelter facilities. Thank you for your interest! If you would like to receive additional information, please email the program coordinator, Charlette Jauch, at adopt@mehs.org. Or you may complete the attached application. Note: The Foster Program is entirely staffed by volunteers. Services performed by an individual are of a voluntary nature and are without express or implied promise of salary, compensation, employment, or payment of any kind. Foster Application page 1 of 3 Metro East Humane Society Foster Parent Application Personal Profile: Name: _________________________________ Home Phone: (___) ___________________ Address: _______________________________ Work or Cell Phone: (___) _____________ City/State/Zip: __________________________ Email: _____________________________ Housing Status (please circle): Own Rent Landlord Name: __________________________ Are you allowed to house animals? YES Live with parents Phone Number: (____) ________________ NO Please describe any restrictions on the number or type of animals that you are allowed to house: ______________________________________________________________________________ ______________________________________________________________________________ Number of adults in household:_______ Ages of children in household (if any): __________ Personal Pet Profile: Please list ALL pets currently a part of your household: Name Dog/Cat Breed Age/Sex Altered Y/N Vaccines (Type and Date last given) Sleeps (Inside/Outside) 1 2 3 4 5 List history of medical issues of the above pets, by line number: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Your veterinarian’s name: ________________________ Phone number: (___) ______________ List two personal references: Reference #1 Name:_______________________________ Phone (____) __________________ Reference #2 Name:_______________________________ Phone (____) __________________ Before fostering, I agree to provide documentation from my vet showing that my animals are vaccinated against the following diseases: Canine: DHPPC/Bordetella, Rabies, Fleas, Internal Parasites, Heartworm Disease Feline: FVRCP/Bordetella, Rabies, Fleas, Internal Parasites (Signature required) _____________________ Foster Application page 2 of 3 Relevant Experience/Information: List all other foster or rescue groups that you are a part of (including caring for feral cats): ______________________________________________________________________________ ______________________________________________________________________________ Is your property fenced? YES NO How high is it at its lowest point? ______________ Foster animals must be kept separate from your pets. Describe area where foster animal(s) will be kept:_______________________________________________________________________ ______________________________________________________________________________ How many hours a day will the animal be alone on a regular basis?________________________ Briefly describe your experience with very young, ill, injured, and/or unsocialized animals: ____ ______________________________________________________________________________ ______________________________________________________________________________ Choices: Describe the minimum and maximum time frames to which you are committed for one or more foster animals:__________________________________________________________________ ______________________________________________________________________________ Which animals are you interested in fostering (circle all that apply)? Weaned healthy kittens Weaned healthy puppies Cats/kittens with a cold Dogs/puppies with a cold Mom with kittens Mom with puppies Ill/Injured cat Ill/Injured dog Orphaned kittens Orphaned puppies Cat behavior cases (non-aggressive) Dog behavior cases (non-aggressive) Describe why you want to be a foster parent:__________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I certify that the above information is true and accurate. I understand that any falsification of the above information may be grounds for denial of this application or termination of my volunteer status. I acknowledge that this application remains the property of Metro East Humane Society. I authorize MEHS to conduct an on-site inspection of the premises where the animal(s) will be kept. Signature: ______________________________________ Date: _________________ Please send completed application to: MEHS, Attn: Foster Program, 8495 State Route 143, Edwardsville, IL 62025 Foster Application page 3 of 3