Foster Application Contact InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Primary Phone*Primary Phone Type* Home Mobile Secondary PhoneSecondary Phone Type Home Mobile Personal InformationAge*18–2526–3536–4546–5556 or olderEmployed* Yes No Name of Employer* Job Title* Have you ever been convicted of a felony?* Yes No Do you have any cats or dogs currently in your care?* Yes No Please provide the following information for each pet in your care. (One per line)Foster InterestI'm interested in (Check all that apply)* Select All Fostering healthy dogs Fostering healthy puppies Fostering healthy cats Fostering kittens Fostering baby bottle kittens (neonate) Fostering mom and kittens Fostering sick/injured dogs Fostering sick/injured cats What does your home/work schedule look like? (Check all that apply)* Home the majority of the day Home for a portion of the day Work from home Flexible work schedule Away from home most of the day What most interests you about fostering with Winnebago County Animal Services?*SignatureBy signing below, I certify that the statements made in this foster application are true and have been given voluntarily. I understand that this information may be disclosed to any party with legal interest, and I release the agency from any liability whatsoever for supplying such information. I also understand that I will not be paid for my services as a foster. In consideration of Winnebago County Animal Services accepting my application for participation in the Winnebago County Animal Services foster program, I agree to release and hold harmless Winnebago County Animal Services from and against any and all loss, damage, claims, liability, costs and expenses of any nature whatsoever, including without limitation, attorney’s fees and disbursements, arising from or occasioned by my participation in the Winnebago County Animal Services foster program. I understand there are certain risks inherent in handling animals and I accept these risks. I agree that Winnebago County Animal Services may photograph my participation in this program, and I hereby release any such photographs to Winnebago County Animal Services for use in its programs, publications, and purpose. I understand that Winnebago County Animal Services reserves the right to refuse my application or dismiss me if I violate Winnebago County or Volunteer policy and procedures.SignatureNameThis field is for validation purposes and should be left unchanged.
