Foster Application

Name:*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Work Phone
Cell Phone*
Email*
Do You:*
- Rent
- Own
Are you currently allowed to house animals?*
- Yes
- No
Number of Adults in your household?*
Number of Children in your household and Ages?*
Who will be the primary caretaker of the foster animal(s)?*
Please list all pets currently living in your household
Please list all pets that have lived in your household in the last 10 years
We ask that your current pets are up to date on their vaccines prior to taking home a foster animal. If requested, would you be able to provide us with vaccine records to keep on file at QHS?*
- Yes
- No
Do your current dogs/cats get along with other dogs/cats?*
- Yes
- No
- Unsure
Please explain:
Please describe where you will keep your foster animal(s) when you are home/not home?*
Where will your foster animal(s) sleep at night?*
How many hours per day will your foster animal(s) be left alone?*
What would you describe as unacceptable behaviors in your foster animal (i.e. Growling/hissing, excessive barking, not housetrained, etc.)?*
What would you do if your foster animal(s) displayed any of those behaviors?*
Under what circumstances would you return your foster animal? (Please describe):*
For what length of time are you willing to foster an animal?*
Are you willing to foster an animal with behavior challenges?*
- Yes
- No
- Maytbe
What types of behavior challenges do you feel you are able to work with?*
Are you willing to foster an animal with special medical needs?*
- Yes
- No
- Maytbe
Please describe any previous experience or training you’ve had working with animals:*
Which of the following special populations are you interested in fostering? Please check all that apply:*
- Adult Cats (Sick or injured)
- Mother with kittens
- Orphaned Kittens
- Distressed Cat or Kitten
- Respite for Cat/Kitten
- Cat/Kitten in need of 10 day quarantine
- Adult Dog (Sick or injured)
- Mother with puppies
- Orphaned puppies
- Distressed Dog or puppy
- Respite for Dog/Puppy
- Dog/puppy in need of 10 day quarantine
*Animals who need to be fostered for the purpose of a quarantine does not necessarily mean that this animal is sick. Many times this quarantine period is done to make sure they are not sick before they are brought into the shelter environment.
I certify that the above information is true and correct. I understand that any falsification of the above information may be grounds for denial of this application. I acknowledge that this application will remain the property of the Quincy Humane Society.
Signature*
Date*
Date Format: MM slash DD slash YYYY
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Hours of Operation

Monday 11:30 - 5:00
Tuesday 11:30 - 5:00
Wednesday 11:30 - 5:00
Thursday 11:30 - 5:00
Friday 11:30 - 6:00
Saturday 11:30 - 5:00
Sunday CLOSED

Phone

(217) 223-8786
Fax: (217) 223-9471

Location

1705 N. 36th St.
Quincy, IL 62305

Mailing Address

PO Box 3173
Quincy, IL 62305

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