Foster Application NameThis field is for validation purposes and should be left unchanged.Humane Society of Central Illinois Foster Care Application Any and all information included in this application is strictly confidential and will not be disclosed to a third party. I understand that HSCI is very concerned about the security and safety of their animals, as well as their ability to keep track of all animals rescued. I understand HSCI respects my privacy, and the information shared here will only be used for the foster program, or as required by law.Consent(Required) I agree that all statements in this application are made based on personal knowledge and are made for purposes of my application to foster one or more animals through HSCI’s foster care program.About MeName(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Primary Phone #(Required)TypeHomeMobileWorkSecondary Phone #TypeHomeMobileWorkEmail(Required) My Home(Required) I own my home I rent my home and have permission from my landlord to foster animals. I understand HSCI may contact my landlord to confirm. Landlord Name First Last Landlord PhoneMy Household and PetsNumber of adults in my home (including not related)(Required)Number and ages of children in my homeNumber of animals currently in my home(Required)All my pets are spayed/neutered and up to date on vaccinations Yes No We require that all personal pets are spayed or neutered and up to date on vaccinations before you foster.Vet clinic or veterinarian(Required)Vet clinic or veterinarian phoneFoster Preferences and AvailabilityI currently foster for another rescue:(Required) Yes No Number of animals I can foster at one time(Required)I'm able and willing to foster:(Required) Puppies Dogs (adult) Dogs (senior) Kittens Cats (adult Pregnant or nursing animals Special needs animals No preference - I'm open to any animals that need care I have the following preferences or limitations (example: breed, size, energy level):Where my foster animal will sleep at night(Required)Where my foster animal will stay during the day when I'm home(Required)Where my foster animal will stay when I'm not home during the day(Required)References and AgreementsTwo people who know me (but are not related to me) and my companion animals and have been to my home recently:Name(Required) First Last Relationship(Required)Phone(Required)Name(Required) First Last Relationship(Required)Phone(Required)Agreements(Required) I understand an HSCI representative may visit my home for a home inspection before my foster application is approved. I understand I must also complete a regular volunteer waiver for HSCI. I understand that if I am approved for fostering, I will be required to read and sign the Foster Care Agreement, which is a separate document from the Foster Care Application. The Foster Care Agreement represents the legal contract between a foster caregiver and HSCI. I agree that all statements contained in this document are made by me, and are truthful. I make this statement under penalty of perjury under the laws of the state of Illinois. Select AllSignature(Required)Date(Required)
