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View Exotic/Other
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Adoption Appointment Form
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Ready to Foster? Fill out the form!
Name
*
First
Last
Email
*
Phone
*
Address
*
Street Address
City
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Vermont
Virginia
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West Virginia
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Armed Forces Americas
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State
ZIP Code
ID State
*
(example: MS - Mississippi)
ID #
*
(example: Your Driver's License #)
Emergency Contact's Name:
*
First
Last
Emergency Contact's Phone:
*
Animal Applying For:
If you do not have a certain animal in mind leave this blank.
Best Time to Reach You:
*
:
Hours
Minutes
AM
PM
AM/PM
Are you wanting to foster a cat or dog?
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Dog
Cat
Both
Why are you interested in fostering?
*
If you are applying for a specific animal, what is its name and why do you want to foster this dog?
If you are not applying for a specific animal leave this blank.
Are there other adults in your household? (If yes, how many and what is their relationship to you?)
*
If you have children in your household, how many and what ages?
*
Is everyone in the household in agreement to foster?
*
Yes
No
Will you be moving in the next 60 days?
*
Yes
No
Select your type of residence:
*
House
Condo
Townhouse
Apartment
Do you rent or own?
*
Rent
Own
If you rent, do you have landlord approval to foster?
*
Yes
No
Do you have a private fenced yard (a fence through which a dog cannot see, that is at least 6 foot high, and is not a communal yard)? NOTE: A private fenced yard is not necessary for fostering.
*
Yes
No
Please describe any yard that you have.
*
Do you have pets in your home? If you do, how many and what are their genders and ages?
*
Are your current animals spayed/neutered?
*
Yes
No
Are your current pets up to date on vaccines, including bordatella?
*
Yes
No
Please list any current medical issues your pets have.
*
If you have other pets, please list your veterinarian and their contact information.
*
Has any animal in your home ever been diagnosed with a serious contagious disease like parvovirus?
*
Yes
No
If so, when was your animal diagnosed with a serious contagious disease like parvovirus?
Please detail any foster experience that you have.
Do you currently have foster dogs?
*
Yes
No
Are you interested in fostering pregnant moms or moms with newborns or interest in learning more?
*
Yes
No
Are you interested in fostering bottle babies or tube-fed babies or interested in learning more?
*
Yes
No
Are you interested in fostering medical cases or interest in learning more?
*
Yes
No
Are you interested in fostering dogs that require more active management or interested in learning more?
*
Yes
No
Are you interested in fostering senior dogs or interested in learning more?
*
Yes
No
Where will your foster dog be kept?
*
How many hours a day would your foster be left alone?
*
What can your provide your foster dogs in terms of care giving and enrichment (play, etc.)?
*
Please list any special concerns or requests you may have.
*
How did you hear about Tupelo Lee Humane Society?
*
Internet Search
Friends/Family
An Adopter
Another Foster
Petco
Petsmart
TV
Radio
Facebook
Instagram
Please complete the rest of this application by checking all boxes.
Please note that if you are unable to agree to all terms, that your application may not be approved.
By agreeing to foster in partnership with Tupelo Lee Humane Society, I agree to the following:
*
I am at least 18 years in age.
I live within 40 miles of Tupelo Lee Humane Society located in Tupelo, MS
I will carefully read all documents and carefully follow all instructions that Tupelo Lee Humane Society provides to me.
I will not take a foster dog unless all my resident animals are fully vaccinated. A fully-vaccinated dog is a dog who has received at least 2 DHLPP or DAPP vaccines, one of which was given in the last 3 years and at the age of 4 months or older, that IS NOT immunocompromised (happens in geriatric [elderly] dogs) or on prednisone or steroids; AND DOES NOT have cancer, Cushing's Disease, or any other sever disease that is compromising their health.
I will keep my foster dog separated from my resident animal(s) for at least the first week.
I will not take my foster dog to a dog park or any other off leash area or let my foster dog off leash.
I will not leave my foster dog unattended in a fenced yard.
I will not introduce my foster dog to any other dogs other than those that reside in my home.
I will not travel out of the area with my foster dog.
I will not hand off my foster dog to a sitter or another foster without first discussing it with the Dog Foster Team.
I will not hand off my foster dog to a potential adopter or let them take my foster dog on a trial basis, field trip, or sleepover before the completion of the official adoption process or without approval from the Dog Foster Team.
I will actively participate in marketing my foster dog and be responsive and courteous towards each potential adopter pursuant to the adoption process protocol that will be emailed to me.
I confirm that I am willingly offering to foster and that I do not expect any good or services in return, including an adoption fee reduction or waiver should I decide to adopt my foster dog.
I acknowledge that the decision as to who adopts my foster dog rests with Tupelo Lee Humane Society.
I will immediately report any foster do bite pursuant to the Dog Foster Bite Protocol. A copy of the protocol will also be emailed to me.
I will immediately notify the Dog Foster Team if my foster dog gets loose or is lost.
I understand that our Tupelo Lee Humane Society Team provides all medical care for our foster dogs, and TLHS will NOT reimburse me for the cost of ANY medical care outside of TLHS.
I agree that a TLHS representative may contact my veterinarian to confirm the information provided herein regarding my pets, and I consent to my veterinarian's release of such veterinary information to TLHS.
I agree that TLHS representative may come to my home to check on my foster dog while it is in my care.
I agree that I will not place my foster dog in another person's care, and I am solely responsible for adhering to all guidelines set by TLHS in this application.
Pet's Health and Disposition
Tupelo Lee Humane Society cannot guarantee the health or disposition of any foster animal. We do not have past records for these animals and there are some risks associated with taking in foster animals. Family pets will be current on all shots and foster pets will be kept isolated from family pets, for a minimum of 7 days for the protection of all animals. I agree to be fully responsible for the safety and well being of the foster pet. I will provide a safe, loving, humane environment with adequate food, water and shelter at all times. I will not declaw, crop ears, or crop tail of fostered pet. I will adhere to all state and local animals laws and all foster animals will wear a collar with identification. I will promptly notify Tupelo Lee Humane Society of any signs of illness, behavioral issues or concerns, an inability to continue to foster, if the pet becomes lost, and/or if the pet(s) bites someone.
Transfer of Animals
Animals cannot be transferred to the custody of another person, shelter, humane society, SPCA, or other entity without prior consent and permission of Tupelo Lee Humane Society and must be returned within 24 hours of request. I agree that I am fostering this pet for Tupelo Lee Humane Society and that I do not have any right of ownership over my foster animal. I further agree that Tupelo Lee Humane Society’s rights in and to my foster pet are superior to mine. I agree to provide the TLHS authorized representative, or his/her designate, access to my home and property to check on my foster pet at any time while I am in possession of my foster pet.
Personal or Property Damage and/or Injury
I agree that accidental animal bites or other injuries to humans and other animals do occur, and agree to hold harmless and indemnify, and protect Tupelo Lee Humane Society from any claim or suit filed by someone as a result of such incident. In addition, Tupelo Lee Humane Society will not be responsible if an animal should damage or destroy property belonging to the foster caregiver (signee of this form), the foster caregiver’s household, or others, or if the animal shall transfer any disease, internal or external parasites to other animals or people in the foster caregiver’s household. I understand that if I am approved for fostering, this declaration represents a legal contract between me and Tupelo Lee Humane Society. I understand that I the designated foster caregiver for all animals owned and cared for by Tupelo Lee Humane Society. I understand that if I am approved to foster an animal, I must abide by this agreement and that this agreement applies to any and all animals that I foster with Tupelo Lee Humane Society.
Accuracy of Information
I acknowledge that the information provided on this application is correct to the best of my knowledge. If at any time the information I have provided changes, I will provide the updated information to the Tupelo Lee Humane Society.
By typing your name in the blank below, you agree that you have read and will abide by all requirements and guidelines for fostering through TLHS (Tupelo Lee Humane Society):
*
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Phone
This field is for validation purposes and should be left unchanged.
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