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WELCOME! Dear Prospective Foster Caregiver, Please fill out (Kitsap Humane Society)

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1
Kitsap Humane Society
9167 Dickey Rd NW
Silverdale, WA 98383
P: 360-692-6977
WELCOME!
Dear Prospective Foster Caregiver,
Please fill out this application to begin the process of becoming a foster parent with KHS! We do not share information
gathered in this application outside of KHS. Call us at 360-692-6977, ext 1207 or e-mail foster@kitsap-humane.org with
any questions you may have.
Thank you for your interest,
Holly Faccenda
KHS Foster Care Coordinator
Foster Caregiver Application
Name (first and last): ________________________________________________________________________
Date of Birth _____/______/_______
Are you at least 18 years of age? ☐Yes ☐No
If not, please specify your age: ________
Volunteers ages 16 and 17 must have written approval from a parent or legal guardian; e-mail the Foster Care
Coordinator for form.
How did you find out about KHS’ Foster Care Program?
__________________________________________________________________________________________
Demographics
Please provide your current street address. If your mailing address is different, please include it.
Address: __________________________________________________________________________________
Address (line 2): ____________________________________________________________________________
City/Town: _____________________________________ State: ___________ Zip Code: _________________
Email Address: _____________________________________________________________________________
*Please double check for accuracy, as this is our primary means of communication.
Please list the phone numbers at which we can reach you. Be sure to include your area code.
Home Phone Number: __________________________ Cell Phone Number: ____________________________
Driver’s License Number: ___________________________
2
Kitsap Humane Society
9167 Dickey Rd NW
Silverdale, WA 98383
P: 360-692-6977
Fostering Preferences
In order to better match foster caregivers with animals in need, it would help us to know your preferences
for any future foster assignments.
Very Interested Might Be Interested Not Interested
Adult Cats ◦ ◦ ◦
Mom Cats with Unweaned Kittens ◦ ◦ ◦
Kittens ◦ ◦ ◦
Adult Dogs ◦ ◦ ◦
Mom Dogs with Unweaned Pups ◦ ◦ ◦
Puppies ◦ ◦ ◦
Cage birds ◦ ◦ ◦
Reptiles/Amphibians ◦ ◦ ◦
Livestock ◦ ◦ ◦
Many times, the animals who need foster care have medical conditions or need behavior modification in order
to ready them for adoption. This can include underweight animals, animals recovering from surgery, animals
with treatable skin conditions, shy or fearful animals, elderly animals, animals in need of household manners
training, and animals with more severe behavioral needs. You are not obligated to take on any foster animal
you are not comfortable with, and fostering is completely at-will.
Are there any behaviors or medical concerns that you are absolutely not comfortable with in a foster
animal? _____________________________________________________________________________
About Your Home
To help us better match animals with foster caregivers, please tell us about your home environment and animal care
skills.
Where do you live? (check one)
□ single family home □ duplex/condo □ apartment □ mobile home □ assisted living complex
Landlord status?
□ own □ rent/lease
For dogs only:
Do you have a yard?
□ No □ Yes, unfenced □ Yes, fenced - fence type and height: _____________________
How do you plan to keep the dog contained? ______________________________________________
3
Kitsap Humane Society
9167 Dickey Rd NW
Silverdale, WA 98383
P: 360-692-6977
Who do you live with?
Name
Age
Relationship to Applicant
Are all members of your household aware and supportive of your interest in fostering? ☐Yes ☐No
How many animals live in your home as permanent residents (your own pets)?
Type/Breed
Age
# of Years
Owned
Spayed/Neutered?
Do your personal pets get along well with other animals? ☐Yes ☐No
If no, please specify: _________________________________________________________________________
Do you have an area that can be isolated from personal pets and easily disinfected (no carpet, i.e. bathroom)?
☐Yes ☐No
If yes, please specify:
__________________________________________________________________________________________
Would you be able to come to the shelter every couple of weeks for your foster animal’s vaccine boosters and health
checks? ☐Yes ☐No
Please list any special training or experience in animal handling or care that you have had:
4
Kitsap Humane Society
9167 Dickey Rd NW
Silverdale, WA 98383
P: 360-692-6977
Foster Program
Are you willing to take a foster training class at KHS? ☐Yes ☐No
If yes, what are the best times for you: __________________________________________________________
Are you willing to allow a home inspection by a KHS staff member? ☐Yes ☐No
If yes, what are the best times for you: __________________________________________________________
If it is decided by KHS that a foster animal needs to be humanely euthanized for health or behavior reasons once the
animal is back in the adoption system, do you want to be notified of this decision beforehand? Please note that we do
our best to contact foster caregivers, however if we do not reach you in a timely fashion and the issue is urgent, KHS
reserves the right to make this decision at any time.
_____ YES, I want to be contacted in this situation
_____ NO, I do not want to be contacted
Why are you interested in fostering with KHS?
Please list any concerns or questions you have about fostering so we can discuss them with you:
5
Kitsap Humane Society
9167 Dickey Rd NW
Silverdale, WA 98383
P: 360-692-6977
Please read the through these foster policies and initial to indicate you agreed to comply:
_____ I agree to comply with all local and state laws and ordinances relating to the care of domestic animals and will not
engage in any illegal activity with my foster animal.
_____ I understand that no foster animal is allowed outside unattended and unrestrained.
_____ I understand that no foster animal is allowed to be left unattended with children.
_____ I understand that there are no guarantees of the behavior, health, or disposition of my foster.
_____ I understand that the animal I am taking into foster care may not be housebroken and I am willing to train the
animal and give it time to adjust to house/litter box breaking and crate training. I understand that the animal I am taking
into foster care may not be used to living indoors and may scratch or soil my furniture or belongings.
_____ I understand that the shelter environment is very stressful, and my foster animal may take some time to adjust to
new situations, people and other animals in the home.
_____ I will use only positive reinforcement for training and will not use any kind of physical punishment or fear-based
training, regardless of the behavior issues.
_____ I understand that foster pets are to be kept separate from personal pets for 2 weeks, with the exception of adult
dog fosters interacting with owned adult dogs.
_____ I understand that a foster animal cannot interact with other pets outside my home. For adult dogs, I understand
that if I have other adult dogs in my home, I am required to bring my pets to KHS to do an introduction with the foster
dog before I am permitted to bring that pet into my home. I understand that I am not permitted to take my foster dog to
dog parks of have it meet other dogs that are not my own, including friends and neighbor’s dogs.
_____ I understand that I am responsible for transporting the foster animal to the shelter for veterinary appointments
and vaccine booster appointments when necessary.
_____ I understand that it is my responsibility to e-mail the KHS Foster Care Coordinator weekly to report on the
condition and status of the foster animal.
_____ I understand that all veterinary visits and procedures happen at KHS and I am not permitted to take my KHS foster
animal to an outside veterinary clinic.
_____ I understand that a foster animal cannot be adopted until they are spayed/neutered.
_____ I understand that a foster animal cannot be given away to a new home without the adopter coming to KHS to
finalize all adoption paperwork. I understand that I am not responsible for adopting out my foster animal and that if a
friend or family member wishes to adopt my foster animal, the animal will not be placed on a Hold and all normal
adoption processes and policies apply.
_____ If I decide that I cannot follow through on my foster care commitment, I will give 24 hours notice and notify the
Foster Care Coordinator; but if at any time I feel that my safety or the safety of my family or resident animals is at risk I
can return my foster animal immediately.
6
Kitsap Humane Society
9167 Dickey Rd NW
Silverdale, WA 98383
P: 360-692-6977
Kitsap Humane Society Volunteer Agreement
In signing the application, I understand and agree to the following:
• I agree to attend all required training classes. I agree to abide by the policies and procedures presented to me at
the volunteer orientation and training workshops. I understand that if I do not follow rules established by the
Kitsap Humane Society, I may be subject to corrective action and/or termination from the Volunteer Program.
• I understand that if I am injured while acting as an unpaid member of the volunteer staff, I am not covered by
Washington State Workers Compensation Law. I authorize the Kitsap Humane Society to seek emergency
medical treatment in case of accident, injury or illness. I agree to hold the Kitsap Humane Society, its employees,
volunteers and officers harmless in all matters relating to my service as a volunteer, including but not limited to
personal injury.
• I agree on behalf of myself, my heirs, personal representatives and executors to allow the Kitsap Humane
Society to use any photographs or videotapes taken of me for use in public relations efforts.
• I understand that I am a representative of the Kitsap Humane Society and that I may have access to personal or
privileged information regarding the organization. I agree to respect and maintain confidentiality of all donors,
customers, volunteers, staff and animals of the Kitsap Humane Society both on and offsite, during and outside of
volunteer hours. I understand that any disrespectful or misleading representation of the Kitsap Humane Society
may be cause for immediate dismissal from the Volunteer Program.
• I understand that because I handle animals, it is important to discuss being vaccinated against tetanus with my
physician. I release the Kitsap Humane Society from all responsibility that may occur because of my not
pursuing this matter further, and I understand whatever decision I make is at my own risk.
___________________________________________________________ ________________________
Signature Date
___________________________________________________________
Print Name
FOR MINORS AND GUARDIANS
If under 18, parent or legal guardian must also sign.
I understand that if my child is under the age of 16, he/she will need to be accompanied by a parent or adult.
___________________________________________________________ ________________________
Parent/Guardian Signature Date
Thank You!
Please submit this application to the Customer Service Desk at the Kitsap Humane Society, or email it to foster@kitsap-
humane.org. Please don’t forget to check your spam box for our email accepting you into our foster program!
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WELCOME Dear Prospective Foster Caregiver, Please fill out (Kitsap Humane Society)

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Completed 31 January 2021

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