EAU CLAIRE COUNTY HUMANE ASSOCIATION
Foster Application

Must be 21 years old or older to foster

Cat
Dog
Other

if other, please specify which type of foster:


In order to be considered to be a foster home for ECCHA pets, you must:

  • Be 18 years of age
  • Have the knowledge and consent of all adults living in your household
  • Have verifiable identification
  • Understand that the ECCHA has the right to deny your application
  • Agree to a home visit BEFORE and DURING the time when you might foster a pet from ECCHA

So that we may be assured that the relationship between the fostered pet and you, the fostering family will be a good one, we would like you to provide us with the following information.

This form should take approximately 10-20 minutes to complete. Thank you for your cooperation.

1. What ages of cat/dog do you prefer to foster?
2. Will you foster a mom and her litter? yes no
3. Will you foster a pet with special needs? yes no
4. How long are you willing to foster?
5. How many pets would you foster at one time?
6. Please list any other preferences or restrictions:
7. Why do you want to foster?
8. Would you be willing to bring in the pet to the shelter for viewing? yes no
10. How flexible is your schedule (how much notice do you need to bring the pet in to the shelter)?

  So that we may be assured that the animal you want to foster will be best suited for you, your home and lifestylSe, we would like you to provide us with the following information. This form should take approximately 10-15 minutes to complete. Thank you for your cooperation.

  * = required fields for this form to work

ABOUT YOURSELF    
*Name:
*Email:
*Street Address: 
*Home Phone:
(xxx-xxx-xxxx)
*City:
*County:
*State:
*ZIP:
Date of Birth
 (mm/dd/yyyy)
Cellphone:
(xxx-xxx-xxxx)
Employer: 
Occupation:
How long at current job?:
 years
Work Phone#
 (xxx-xxx-xxxx)
How many years have you lived at the above address?
  years
Your Previous address (if less than 5 years)
City
County:
State:
ZIP:
Co-applicant (Spouse or Significant Other):
 Date of Birth? (mm/dd/yyyy)
First Name:
  Last Name:
Employer:
 Occupation:
How long at current job?:
 years    

ABOUT YOUR HOME:
You live in: trailer/mobile home Apartment House
Do you: rent home own home  
Other Family Members:
How many people are currently living at this residence?
Men:
number?
ages?
Women:
number?
ages?
Girls
number?
ages?
Boys:
number?
ages?
Please tell us the names of the people in your household:  
Do you plan on moving in the
next 6 months?
 Yes No Would your pet go with you if you moved?
 Yes No

List animals you currently own or that are in your care/house and those you have owned in the past five years, if you need more room list in comment box below:
Dog
Cat
Other		 Name

If other, what:

Breed:
Male
Female

Spay/Neuter
Yes
No 		Housed
Inside
Outside
Both 		How long
Owned?
years		 Where is it
now?
Dog
Cat
Other 		Name

If other, what:
 Breed:
Male
Female 		Spay/Neuter
Yes
No 		Housed
Inside
Outside
Both 		How long
Owned?
years 		Where is it
now?
Dog
Cat
Other 		Name

If other, what:
 		Breed:

Male
Female 		Spay/Neuter
Yes
No 		Housed
Inside
Outside
Both 		How long
Owned?
years 		Where is it
now?
Dog
Cat
Other 		Name

If other, what:
 Breed:

Male
Female 		Spay/Neuter
Yes
No 		Housed
Inside
Outside
Both 		How long
Owned?
years 		Where is it
now?
Dog
Cat
Other 		Name

If other, what:
 Breed:

Male
Female 		Spay/Neuter
Yes
No 		Housed
Inside
Outside
Both 		How long
Owned?
years 		Where is it
now?
Dog
Cat
Other 		Name

If other, what:
 Breed:

Male
Female 		Spay/Neuter
Yes
No 		Housed
Inside
Outside
Both 		How long
Owned?
years 		Where is it
now?
Dog
Cat
Other 		Name

If other, what:
 Breed:

Male
Female 		Spay/Neuter
Yes
No 		Housed
Inside
Outside
Both 		How long
Owned?
years 		Where is it
now?

ABOUT FOSTERING IN YOUR HOME
Have you applied to adopt or foster from our Shelter or other animal shelter before?
yes no
If from another shelter, which one?
What veterinary hospital do you use (or do you plan to use)?
Are your current pets up-to-date with their vaccinations?

Under whose name are the veterinarian hospital records?
Please list your veterinarian's phone number
(xxx-xxx-xxxx)
If no, please explain:
Who is going to be the main caregiver?
What best describes the main pet caregiver?  (check all that apply)

Do any family members have allergies?
Yes No
Have you ever given a pet up because it didn't work out?
Yes No
If so, please explain the circumstances and what happened to it:
On an average day, how long will your foster be left without human companionship?
hours
Are you familiar with the pet laws in your area?
Yes No
What brand of food do you plan to feed?
What type of ID will your foster wear?
How do you plan on exercising your foster?
Do you plan to allow your foster outdoors?
Yes No
If yes, under what circumstances
If you rent, do you have the landlord's permission to foster an animal?
if yes, who is the landlord?
What is the landlord's phone number?
(xxx-xxx-xxxx)
Are the people in your home experienced with this kind of animal?
Yes No
Is everyone in the household agreeable to fostering?
Yes No

Where do your current pets stay when home alone during the day? check all that apply)
outside in fenced area
outside in dog pen
outside on chain or tie-out
inside in basement
in the garage
inside free run of house
inside in one room of house
inside in crate ;
other, please describe:

Where will your foster cat stay when home alone during the day?
outside in fenced area
outside in dog pen
outside on chain or tie-out
inside in basement
in the garage
inside free run of house
inside in one room of house
inside in crate ;
other, please describe:

Where do current pets sleep at night?
dog house in fenced area
dog house in dog pen
dog house near tie-out
inside in basement
in the garage
inside free run of house
inside in one room of house
inside in crate
in my bed
other, please describe:


Where will your foster cat sleep at night?
inside in basement
in the garage
inside free run of house
inside in one room of house
inside in crate
in my bed
other, please describe:
Please enter any additional comments that you may have regarding this application:

For applicants outside of Eau Claire County:
References, outside of your family:
  Name Phone Number
1
 (xxx-xxx-xxxx)
2
 (xxx-xxx-xxxx)
3
 (xxx-xxx-xxxx)

Please list your area shelters and their phone numbers
  Shelter Phone Number
1
 (xxx-xxx-xxxx)
2
 (xxx-xxx-xxxx)
3
 (xxx-xxx-xxxx)

The undersigned applicant hereby grants the Eau Claire County Humane Association permission to confirm any information provided in this application with any appropriate third party source, including landlords, veterinarians, etc. The information obtained will be held in confidence and used only by the Eau Claire County Humane Association for purposes of this adoption application.

I certify that all the information on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected. I also understand that this adoption application is the sole property of the Eau Claire County Humane Association.

It is specifically understood that the Eau Claire County Humane Association reserves the right to deny any adoption application at its own discretion.

Typing your name below will serve as legal signature.
By signing below, I am attesting to the truthfulness of my answers. Falsification of any of the above information will be grounds for disallowing the adoption of rescue cat and possible removal of said cat from my home. Applicant must be 18 years of age or older. We reserve the right to refuse any applicant.
Date: Driver's license #:

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click HERE to download an interactive adoption form in .pdf format
THEN:
Download the form, type in the data, save the form, and send as an attachment
Fax it to us at (715) 839-1664,
-OR-
Snail Mail it to us at: ECCHA
3900 Old Town Hall Rd,
Eau Claire WI 54701