Foster Care Application

Name: / Date:
Street Address: / City: / State: / Zip:
Mailing Address: / City: / State: / Zip:
Cell Phone: / Work Phone:
Email: / May we add you to our foster email list? Yes No
Occupation/Employer: / Full Time Part Time Home Retired Student
What’s your living situation? / House Townhouse Apartment Mobile Home Other ______
Rent/Lease / Own
Apartment complex or association: / City of Harrisonburg
Rockingham County
Augusta County
Shenandoah County
Page County / Other:
Name of landlord/owner/property manager:
Phone number: / Name on Deed:
Who else lives in your home? Just me Children Parent(s)/Guardian Roommate(s) Other ______
Name / Age / How long is this person usually home during the day? / Is this person allergic to cats/dogs/other animals?
Do you have any other pets living in your home? No Yes, my own pets. Yes, fosters for another org.
Name / Age / Species / Breed / Sex / Spayed/
Neutered / Activity Level
(low/med/high) / Gets along with other animals?
Veterinarian: / Phone Number:
What type of animal(s) would you be interested in fostering? (check all that apply)
  Dogs
  Cats
  Puppies
  Kittens
  Small mammals and birds /   Momma dog with puppies
  Momma cat with kittens
  Bottle feeding puppies
  Momma cat with kittens
  Bottle feeding kittens
Would you be willing to attend training about providing medical care to foster animals? Yes No
I certify that the above information is correct to the best of my knowledge. I also agree to follow all the rules, regulations and policies of the Rockingham-Harrisonburg SPCA. No person residing in the household has ever been convicted of animal cruelty, neglect or abandonment.
Signature:______

Home Visit Questionnaire

This section to be completed together by the
potential foster care provider and RHSPCA staff.

The Rockingham-Harrisonburg SPCA conducts a home visit for each potential foster care provider prior to approving a foster application. The purpose of this tour is to make sure that the space in your home is adequate for the type of animal(s) that you might foster for the shelter. The visit is also an opportunity for you to speak with shelter staff to discuss any questions or concerns you have.

Question / OK
Where will the animal sleep at night?
Where will the animal be during the day?
How long will the animal be alone?
Where will the animal eat and drink?
Where will the animal pee and poop?
How will you clean the area?
Where will the animal exercise or play?
Will the animal interact with any other animals in the home?
Will you introduce the foster to your pets? If so, how?
Will the animal go outside? (Cats must remain indoors at all times.)
Dogs only
Does the home have a yard? Or access to a dog park or fenced area?
Is there a fence all the way around the area? How high is the fence?
Any gaps or spaces where a dog could get out? Gate that shuts or locks completely?
NOTES: