TEST APPLICATION - Hamilton Humane

TELL US ABOUT YOURSELF
Name*
First Last
Address*
Please note, we are located in Fishers, Indiana, USA.

Street Address Address Line 2 City State ZIP Code
Email*
Driver's License Number*
Date of Birth*
MM slash DD slash YYYY
Cell/Other Phone*
Home Phone
Work Phone
Emergency Contact*
Please, list someone other than yourself.
First Last
Emergency Contact Phone*
Occupation:*
Are you at least 18 years of age?*
- Yes
- No
How did you hear about the shelter or the animal you'd like to adopt/foster?*
Please Explain:*
Do you plan on adopting or fostering the day you come to the shelter?*
- Yes
- No
- Unsure

Areas of Interest
I am interested in:*
Check all that apply
- Adopting
- Fostering
- Both
I am interested in adopting a:*
- Cat
- Specific Cat
- Dog
- Specific Dog
- Either
Name of the cat or dog you'd like to adopt.*

TELL US ABOUT YOUR HOUSEHOLD
Tell us about your current housing situation*
- Own my own home
- Own my own condo
- Renting an apartment/condo
- Renting a house
- Living with parents/relatives
- Live in a trailer/mobile home
- College Fraternity/Sorority Housing
How long have you lived at this address?*
Do you plan on moving within the next 6 months?*
Landlord's Name:*
First Last
Landlord's Phone Number:*
Have you discussed fostering with your landlord?*
- Yes
- No
Are there any pet restrictions in your lease or homeowner's association covenants?*
Please be advised that HSHC requires a copy of your pet policy.

TELL US ABOUT YOUR FAMILY & VISITORS
Please tell us about your current household*
- Live Alone
- Adults Only
- Family with children
Please, list the names and ages of all persons living in your home including yourself.*
Click the "+" on the right of the row to add additional rows.
Person Age
Is any member of your household allergic to animals?*
- Yes
- No
If yes, they are allergic to:*
- Cats
- Dogs
- Both
Do you have visitors often?*
- Yes
- No
What is the frequency of visitors in your home?*
Babysitters, Nannies, Extended Family, Significant Others, Neighbors, Friends, etc.
Are there children/grandchildren who visit your home REGARDLESS OF FREQUENCY?*
Anyone under the age of 18 is considered a child.
- Yes
- No
Please, list ages of each child that visits and how often they visit.*
Child Age Visit Frequency
Do you anticipate the addition of new household members in the near future?
New baby, Parents/Siblings moving in, Roommates
- Yes
- No
The activity level in your home is*
- Quiet
- Active
- Very Active

TELL US ABOUT YOUR PETS
Do you currently have any pets?*
- Yes
- No
Current Pets*
Breed/Mix Sex & Age Spayed/ Neutered? Length Owned? Indoor/ Outdoor? Current on Vaccines?
Name of your Veterinarian Or Clinic*
Veterinarian's Phone
If one of your current pets is not spayed/neutered, please explain why.*
Please put "N/A" if not applicable
If one of your current pets is not current on vaccines, please explain why.*
Please put "N/A" if not applicable

Please tell us about your PAST pets (adult life only - past 10 years).
Have you ever surrendered or rehomed a personal pet to this or any other shelter/rescue group?*
- Yes
- No
Please, explain.*
In the past 10 years have you had any pets you no longer own (passed away/rehomed/run away/etc.)?*
This does not include pets your parents owned, when you were under 18 years of age.
- Yes
- No
Past Pets (adult life only - past 10 years)*
Breed/Mix Sex Spayed/ Neutered? Length Owned? What Happened? (passed/ rehomed/ etc.) Age When Passed/ Rehomed?
Planning Ahead
Owning a pet can be at a MINIMUM a 10 year commitment.*
Do you have any questions or concerns with this time commitment?
- No
- Yes
If yes, please explain:*
The average annual budget to provide basic care for a pet is estimated at $1,500/year, not including medical issues that may arise.*
Do you have any questions or concerns with this financial commitment?
- No
- Yes
If yes, please explain:*
Are you planning to move or change jobs in the next 3-6 months?*
- Yes
- No
Please understand that your application does not guarantee the adoption of the animal you have applied for. The pet you are interested in may not be a good fit for your particular situation. We will keep your application on file for 6 months and contact you if we have an animal that matches your criteria. Please check yes to consent:*
- Yes
- No
Foster Contract Agreements
This animal is a foster and belongs to the Humane Society for Hamilton County.*
- I Agree
If you decide you want to adopt this animal you understand that there will be an adoption fee which you will be responsible for paying.*
- I Agree
The adoption will not be complete until all adoption paperwork is completed, the animal is microchipped, the adoption application is approved and the adoption fee is paid.*
- I Agree
The Humane Society for Hamilton County cannot guarantee the health of any animal. Even though an animal appears healthy there is still a chance it has been exposed to something at the shelter and could get sick later. Please keep fosters separate from family pets for a few days to ensure they are healthy.*
- I Agree
Should this animal need medical treatment or supplies you need to contact the Humane Society for Hamilton County Foster Department to get permission to take the animal to one of our participating vets. If you fail to do this we cannot guarantee reimbursement for any money you pay out of pocket.*
- I Agree
We appreciate you trying to find your foster a permanent home while they are in your care but please note that before the animal changes hands any potential adopters will have to complete an adoption application and have the adoption approved.*
- I Agree
The Humane Society for Hamilton County appreciates you calling in advance to schedule an appointment with the foster department when bringing your foster animal(s) in for vaccines, check-ups or return.*
- I Agree
By checking "I Agree" I certify that all of the above information is true and I understand that giving false information or leaving out pertinent information is grounds for denial. I understand that the Humane Society for Hamilton County has the right to deny a foster at any time for any reason.*
- I Agree
Please, tell us anything else you would like us to know.
Signature*
Please type your legal name.

Step 1 of 8

TELL US ABOUT YOURSELF

Areas of Interest

Foster Questions

TELL US ABOUT YOUR HOUSEHOLD

TELL US ABOUT YOUR FAMILY & VISITORS

Matchmaking Questions

TELL US ABOUT YOUR PETS

Please tell us about your PAST pets (adult life only - past 10 years).

Planning Ahead

Foster Contract Agreements

Breed/Mix	Sex & Age	Spayed/ Neutered?	Length Owned?	Indoor/ Outdoor?	Current on Vaccines?

Person	Age

Child	Age	Visit Frequency

Breed/Mix	Sex	Spayed/ Neutered?	Length Owned?	What Happened? (passed/ rehomed/ etc.)	Age When Passed/ Rehomed?