Wufoo

P.E.I.H.S. Application To Foster Animals Form

"Speaking For Those Who Cannot Speak For Themselves"

Personal information:

Please enter all information asked for.
Your name: * First Last
Are you over 18? * Yes No
Civic address:

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home phone: - (###) - ### ####
Work phone: - (###) - ### ####
Cell phone: (if you have one) - (###) - ### ####
Email:
Household information:

Check all fields that apply.
Home environment: Own my home Rent Live with my parents Fenced yard
Landlord's name: First Last
Required if you rent.
Landlord's phone: - (###) - ### ####
Required if you rent.
Number of adults in the home:
Number of children:
Ages of children:
Work status: Work outside the home Work at home Attend school Retired
Number of animals currently in the home:
Dogs:
Cats:
Other:
Are their vaccinations up to date? Yes No
Are they spayed/neutered? Yes No
Did any of your animals die of an infectious disease in the last 6 months? Yes No
Name of veterinary clinic:
Where will the foster pet(s) stay during the day?
How many hours a day will the foster pet(s) be alone?
I am able to foster cats (check all that apply): Sick cat/kitten Post surgery care Shy/undersocialized cat/kitten Pregnant cat (including taking care of the kittens after birth until they weigh 2 pounds) Mother cat and kittens Orphaned kittens (older than four weeks) Underweight kittens
I am able to foster dogs (check all that apply): Sick dog Post surgery care Shy/undersocialized dog Kennel stressed dog Pregnant dog (including taking care of pups after birth until time of weaning) Orphaned puppies (older than four weeks)
What size dog can you foster? small (<25 lbs) medium (>25 - 60 lbs) large (>60 lbs)
References:

Please provide two references (non-family members.
Reference # 1 name: *
Reference # 1 phone: * - (###) - ### ####
Reference # 2 name:
Reference # 2 phone: * - (###) - ### ####
Important information:

● The PEIHS will provide the necessary food, medication, and supplies, for your foster pet, with the understanding that you will keep the pet until it is deemed ready for adoption by the shelter staff. If for any reason you are no longer able to keep your foster pet you will give the:
PEIHS 24 hours notice before bringing the animal back to the shelter;

● I agree to phone or E-mail the PEIHS once a week with a short update on the foster animal;

● Foster animals remain the property of the P.E.I. Humane Society until time of adoption.

● If you have any questions regarding your foster pet please contact the PEIHS at 902-892-1190/1191 or info@peihumanesociety.com.

I have read and understand everything on this form.
I certify that the information I have provided is accurate to the best of my knowledge.
Signature:
Date / MM / DD YYYY
Date / MM / DD YYYY
Do Not Fill This Out

Wufoo

P.E.I.H.S. Application To Foster Animals Form

Personal information:

Household information:

Number of animals currently in the home:

References:

Important information: