Columbiana County Humane Society

Horse/Farm Animal Foster Application

Columbiana County Humane Society takes in abused, neglected, and abandoned animals; as well as those that are sometimes ordered removed by the courts. We make every attempt to screen our animals for health, behavior, and temperament issues. Certain types of problems may not demonstrate themselves until the animal is in a home environment.

For these reasons we cannot guarantee the behavior, health, or temperament of any animal.

Date * +

Animal Name(s): *

First and Last Name *

Address, City, State, Zip *

Primary Phone Number *

Secondary Phone Number

Email Address *

Type of Residence *

Do you own, rent, or live with friends/family? *

How long have you lived here? *

If you are renting, please provide you landlord's name and phone number

Please list the names and ages of all household members. *

Does anyone in your house have allergies to animals? *

Is this the first time you have had an animal as an adult? *

Does anyone in your household/family have any medical conditions and/or currently on blood thinners? *

Please provide your Veterinarian's name and phone number, if available (otherwise, N/A) *

Please list all animals that currently have or that you have owned in the last three years. Name, breed, age, sex, and whether they are spayed/neutered. If you do not own them anymore, please explain why. *

Please describe what kind of pet you want to foster (horse, pony, goat, pig, poultry, other), male/female, young/old, etc. *

Please select all the qualities that you are looking for in a foster animal (check all that apply): *

What are some training needs that you do not wish to encounter? (Check all that apply) *

Are you willing to train your foster animal if he/she displays some behavioral problems? *

yes

no

If your foster animal does display any of those behaviors listed above, how will you go about teaching him/her? *

How would you describe your household? *

What type of facilities do you have for farm animals? (check all that apply) *

Will your foster pet sleep indoors or outdoors at night? *

Where will the foster animal spend most of its time? *

How many hours a day will your foster animal spend unsupervised? *

What do you do for a living? *

What is your source of income? *

If employed, employer name and number? *

Are all family members in agreement about fostering an animal? *

yes

no

Are you willing to be a foster-to-adopt? *

yes

no

Will you allow us to complete a home check? *

yes

no

Have you, or any member of your household/family been subject to legal action for cruelty to, neglect of, or abandonment of an animal? *

yes

no

Are there any topics that you would like to discuss with our foster coordinator?

I understand that if approved, I will also have to agree to the terms and conditions of the Fostering Contract which is a separate document from the application. I may not take a foster animal home before I agree to the Fostering Contract and approved for fostering. I have read and agree that all statements made in this application are made based on personal knowledge and are made for the purpose to foster one or more animals through the Columbiana County Humane Society. CCHS reserves the right, at our sole discretion, to refuse any applicant for any reason. *

I understand

I do not understand