Humane Society Office: 410-749-7603

Wicomico County Animal Control: 410-749-1070

Salisbury City Animal Control: 410-548-3165

Dog Foster Application

    Please Answer ALL Questions. There may be some that do not apply to you. For example, If you own your house you do not need to provide landlords name and phone number. IF ANY QUESTION DOES NOT APPLY TO YOU PLEASE ANSWER WITH "N/A"! IF ANY QUESTION IS LEFT BLANK UPON SUBMISSION WE WILL BE DELETING YOUR APPLICATION!

    Your name:

    Current date and time:

    Home address (Street Name, Street Number, City, State, and Zip Code):

    Home phone:

    Cell phone:

    Email:

    Your employer:

    I am interested in(Check all that apply)

    Day trips(dogs only)Weekend visit(dogs only)Short term fostering(1 month)Long term foster(>1 month)

    If you chose short term or long term, are you interested in

    Bottle BabiesBaby PuppyMom And Her LitterRehabHospice

    Name and age all of household residents:

    Who will be primarily responsible for the animal?:

    Do you live in A:

    Do you rent, own, or live with parents:

    (If you own just put N/A) Landlord name and phone:

    Are you willing to work through behavioral problems with fostered animal?:

    Do you understand that your fostered animal may expose your resident animals to shelter related illnesses?:

    Have you ever had to give an animal away?:

    What were the circumstances?(if you never have put N/A)

    Where will foster pets be residing?:

    List current pets and any pets that you have had in the past 5 years:

    Current/past 5 years pet breed, type, gender, age, spayed/neutered?:

    What is your veterinarians name and phone number?

    If current pets are not up to date on vaccines or altered, explain why(If they are put N/A)

    Have you fostered with us or any other organization before?

    If yes, when and where?(If no put N/A)

    Are you willing to have a Humane Society representative perform a home check? (If no explain why)

    PLEASE READ IN ITS ENTIRETY AND INITIAL EACH STATEMENT

    Foster animals are property of the Humane Society, do you agree to return the fostered animal at the end of the agreed upon foster terms.

    I agree that this animal is my responsibility and i will follow the rules given by wicomico humane staff

    I will be financially responsible for any injury or incident that occurs while the animal is under my care.

    I agree to keep the dog on a leash at all times or in a fenced in area

    I agree that I will not try to socialize dogs that are deemed reactive.

    I will report any concerns (behavior or health) back to the shelter immediately. if warranted, call animal control at 410-749-1070 or the shelter at 443-880-1788.

    Any additional comments(explain why you chose other)(If none put N/A)

    By signing below, I understand that the falsification or omission of any of the above information will result in automatic refusal of adoption or confiscation of adopted animal. We maintain the right to refuse any application at our discretion. We maintain the right to complete a home check. I authorize HSWC to verify the information in this application. I hereby agree to release, discharge, indemnify and hold harmless the Humane Society of Wicomico County and any of its agents from any and all liabilities that may arise out of the handling by me or my party.

    Sign and date: