The Humane Society of Somerset County, Maryland
Foster Care Provider Application
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Foster Care Agreement
1. You are responsible for the daily care (feeding, exercising, etc.) of the animal for the period in which it remains in foster care at your home.
2. If you are no longer able to care for the animal, you will immediately notify the Humane Society so that other arrangements can be made.
3. You may not rehome any animal without the written permission of the Board of the Humane Society.
Name:_________________________________________________ Date:__________________
Street:________________________________________________
City:______________________________ State:______ Zip:___________
Phone: (home)_____________ (cell)_____________ (work)____________ [ ] Don't call at work.
Have you ever fostered an animal before? Yes____ No____
If yes, what kind of animal did you foster?____________________________________________
When did you foster the animal?_________________________________________________
Are you 18 years of age or older? Yes____ No____ If no, how old are you?____
Are there children in your home? Yes____ No____ If yes, what are their ages?____ ____ ____
Are there elderly or infirm persons in your home? Yes____ No____
Is anyone in your home afraid of large animals? Yes____ No____
Are there any dogs, cats or other pets in your home? Yes____ No____
If yes, how many? Cats______ Dogs______ Other______
Are they spayed or neutered? Yes____ No____
Are they ALL up to date on shots? Yes____ No____
Is your yard fully fenced? Yes____ No____
Do you have a kennel or dog run? Yes____ No____
Who is your Veterinarian?________________________ Location:____________ Phone:_________
Would you consider fostering an older cat, or a cat with special needs? Yes____ No____
How long are you able to foster?  Short Term______ Long Term______ Doesn't Matter______
Can you foster more than one animal? Yes____ No____
If yes, how many animals can you foster?____
How many hours per day will the animal be alone?____
Tell us about yourself...why do you want to be a foster care provider?
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Please ask any questions or make any comments here:
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Adoption Contract
By signing this application you indicate that you are an independent contractor volunteering for The Humane Society of Somerset County, Inc.
Although the animals in your care belong to the Humane Society, the Humane Society cannot be held liable for any damages that the animals may cause to you, your property, or your home while in your care.
Date:__________________
Signature(s) of Foster Care Provider(s):
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Signature of Society Representative:
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