Foster Parent Application

*Preferred Pronouns (she/her, he/him, they/them, etc.)

*First Name

*Last Name

*Email

*Address

*City

*Postal Code

Phone Number (Primary)

*Are you 18 years of age or older? *Are you 18 years of age or older? Yes No

*Are you able to commit to foster for at least six months? *Are you able to commit to foster for at least six months? Yes No

How long do you intend to stay as a foster at OMHS?

*Do you wish to volunteer because you are required to for court ordered community service hours? *Do you wish to volunteer because you are required to for court ordered community service hours? Yes No

*Do you wish to volunteer because you are required to for school? How many hours are needed?

Were you referred to us by any individual or organization? Please Identify the person or organization responsible for making the referral.

*What are your living arrangements *What are your living arrangements Townhouse Apartment House Condo

*Do you *Do you Rent Own

*If you rent, may we contact your landlord to verify that they have no objections to your participation in the foster program? Please provide your landlord’s name and phone number.

Number of adults in the family

Number of children in the family

Ages of children

If you have pets in the family, please provide the following information: type, age, are they spayed/neutered, last date of vaccination, vet clinic your animal(s) go to

Please describe your living arrangements and area of the home where the foster animal(s) will be staying.

*Are you willing and able to keep your foster pet(s) separate from your pet(s) if deemed necessary by the OMHS staff? *Are you willing and able to keep your foster pet(s) separate from your pet(s) if deemed necessary by the OMHS staff? Yes No Not applicable (no pets)

*Do you have any allergies which might be a factor in fostering an animal?

*Do you have any health concerns or limitations which might impact your ability to foster? If yes, please explain.

*What is the reason you wish to foster an animal?

*Please describe any experience you have relating to the type of animal you wish to foster.

Do you currently foster for any other organization? Have you in the past?

Do you have any cages or equipment of your own that you plan to use? If so, what?

Will any other family member(s) be involved in the daily care of your foster animal(s)? Please describe.

Approximately how much time each day can you commit to providing care to a foster animal?

How many hours a day will the animal(s) be alone?

*Indicate time span you prefer to foster: *Indicate time span you prefer to foster: 2-3 weeks 6-8 weeks 3-4 months As long as necessary Other

*Please check off which type of animal(s) you would like to foster: *Please check off which type of animal(s) you would like to foster: Pregnant cats Pregnant dogs Orphan kittens requiring around the clock bottle feeding Orphan kittens eating on their own Puppies requiring bottle feeding Puppies requiring socialization Dogs with medical or behavioural problems Cats with medical or behavioural problems Small animals, birds, reptiles, ferrets Farm animals

*Do you agree to following a training plan where applicable, send short videos of progress and/or check in with our Dog Trainer where required? *Do you agree to following a training plan where applicable, send short videos of progress and/or check in with our Dog Trainer where required? Yes No

*Have you had a tetanus booster in the last 10 years? *Have you had a tetanus booster in the last 10 years? Yes No Unsure

*Have you had a pre-exposure rabies vaccine? (note: not required to volunteer) *Have you had a pre-exposure rabies vaccine? (note: not required to volunteer) Yes No Unsure

*Are you willing to provide references? *Are you willing to provide references? Yes No

*Are you willing to obtain a police background check? *Are you willing to obtain a police background check? Yes No

*Are you willing to complete Accessibility for Ontarians with Disabilities Act (AODA) training? *Are you willing to complete Accessibility for Ontarians with Disabilities Act (AODA) training? Yes No

*Do you have access to a reliable vehicle? *Do you have access to a reliable vehicle? Yes No