Foster Application YOUR INFORMATIONYour Name* First Last Home Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Best contact phone*Email* Your Age Employment Work full-time Work part-time Homemaker Retired Student Name of your employer Marital status SPOUSE (or SIGNIFICANT OTHER) and FAMILY INFORMATIONName of spouse or significant other First Last If you have children living at home, please provide all names and agesNames and ages of any other residents in the home, and relationship to youLIVING SITUATIONResidence* House Townhouse Apartment/condo Other Is there are fully fenced yard?* Yes No If fenced, please give details (height, type of fence, height, materials)Do you own /rent?* How long have you lived at this address? FOSTERING INFORMATIONPlease tell us what type of pet(s) would you like to foster?*(Examples: dog, cat, puppy, kitten, senior pet)Size of dog you prefer: (Small, Medium, Large, No preference)Energy level of dog High energy/likes to walk/run/play Moderate energy/ some walks Low energy/couch potato Are you willing to keep foster pet until adoption? Yes No Have you fostered a pet before for another rescue?* Yes No Under what circumstances would you return your foster pet before adoption?How long will a foster pet typically be alone during the day?*Where will your foster sleep at night?*Are you willing to learn basic training with your foster pet if needed?* Yes No Are you able willing to bring your foster pet to adoption events on Saturdays?* Yes No Sometimes PET HISTORY (CURRENT AND PAST)Do you currently have pets?* Yes No Please describe each pet (dog or cat) breed, ages, spayed/neutered and temperament.Are your own pets current up to date on vaccinations? Yes No Are your dogs currently on Heartworm Preventative? Yes No Which veterinary clinic do you use? Please provide the name and phone number of your veterinarian Please list any pets you had that passed away within the last five yearsPERSONAL REFERENCESPlease list two personal referencesName (personal reference #1)* First Last Best contact phone*Name (personal reference #2)* First Last Best contact phone*NameThis field is for validation purposes and should be left unchanged. MAKE A DONATION THE HUMANE SOCIETY OF UNION COUNTY 704-283-9126 HSUCinfo@gmail.com Mail: 4015 Waxhaw Hwy., Monroe NC 28112 FollowFollowFollow MONROE LOW COST SPAY/NEUTER CLINIC 704-292-7729 Monroespayneuter@gmail.com FAX: 704-292-1007 Hours & Appointments - Click Here 1404 E Franklin St., Monroe, NC 28112 Guidestar Gold Seal of Transparency [/db_pb_signup]
