302 Brickyard Rd
Menonomie, WI 54751
715-232-9790

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Become a Foster for DCHS

Thank you for your interest in becoming a DCHS foster care parent. This application form will help us determine the compatibility of animals in need of fostering with you, your home, and your lifestyle. Please fill out this application completely.

In order to be considered for fostering you must:

❖ be 18 years of age or older

❖ have the knowledge and consent of all adults living in your household

❖ have your landlord’s permission to participate in DCHS’s foster care program

❖ understand that DCHS has the right to approve and/or deny your application

❖ understand that foster homes are sought when an animal is available for placement

❖ agree to a potential home visit prior to animal placement in your home

Foster FAQs

DCHS Pet Foster Application

"*" indicates required fields

Please tell us about yourself and your foster preferences

Please indicate the type of animal you are interested in fostering by marking an “X” in the appropriate box(es):

Cats

Orphaned Kitten(s)

Pregnant Mom with Kittens

Special Needs Cat/Kittens

Cats Needing Socialization

Dogs

Orphaned Puppy(ies)

Pregnant Dog/Mom with Puppies

Special Needs Dog/Puppy

Dog Needing Socialization/Training

Applicant's Full Legal Name:*

Please print

First Last

Applicant's Date of Birth:*

MM slash DD slash YYYY

Co-Applicant's Full Legal Name:

First Last

Co-Applicant's Date of Birth:

MM slash DD slash YYYY

Address:*

Street Address Address Line 2 City State ZIP Code

Main Phone:*

Alt. Phone:

Email*

Preferred Method of Contact

Please check all that apply.

Phone

Text

How long at current address?*

Do you rent or own your home?

Live in a:*

House

Apartment

Condo

Mobile home (own land)

Mobile Home - which park?

Mobile Home Park

If living in a mobile home that sits on land not owned by the applicant then identify the Mobile Home Park:

Have you spoken to your landlord about fostering a dog/cat?*

Yes

Including you, how many people live in your household?

Please indicate the total number of people living in your home here. See the "Household Members Over the Age of 18" section below to add details.

Landlord / Management / Homeowner's Name*

Landlord's Phone:*

Have you fostered before?

Yes

If yes, when?

From DCHS / Other?

Are you currently or planning to foster for any other organization?*

Yes

The primary caretaker is:

Employed Full Time

Employed Part Time

Retired

Stay-at-home

College student

Are there any forthcoming events in your near future (moving, baby, vacation, etc.) which may prevent you from fostering?

Baby

Moving

Vacation

Divorce

Laid Off

N/A

Please explain forthcoming events.

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

How long are you able to provide foster care? (Example: # of days; weeks; months)

Household Members Over the Age of 18

*If there are other adults (age 18+) residing in your home besides yourself, please list their full legal names and date of birth:

(Click the + symbol to add more than 1 person)

First Name:

Middle Name:

Last Name:

DOB:

History of Pet Ownership

What types of pets have you owned during the past 5 years? (Please list animals currently living with you also.)

(Click the + Sign to Add More Pets)

Cat / Dog

Name

Gender

Spayed / Neutered?

Breed

Age

Kept Indoors / Outdoors?

Still Own? (Y/N)

Are your pets up to date with vaccinations?

Yes

I don't know

Your current vet

Your Current Vet's Phone:

Is there any other information you wish to share or feel should be considered when processing your application?

Consent*

The undersigned applicant hereby grants the Dunn County Humane Society (DCHS) permission to confirm any information provided in this application with any third-party sources including landlords, veterinarians, law enforcement, online sources, property records, etc. The information obtained will be held in confidence and used only by DCHS for purposes of this foster care application. DCHS does not discuss application decisions with anyone other than the applicant.

The applicant certifies that all information provided is true and complete and further understands that if any false information, omissions, or misrepresentations become known, the application may be rejected. The information on this application is considered binding.

DCHS reserves the right to deny any foster care placement at its discretion and application does not guarantee pet placement.

I agree to the the following statement:

Applicant's Signature

Electronic signatures NOT accepted

Date*

MM slash DD slash YYYY

Driver's License State:*

Driver's License Number (required):*

Contact Info & Hours

302 Brickyard Road
Menomonie, WI 54751
Phone: (715) 232-9790
Fax: (715) 232-9795

Due to COVID-19, we are doing everything by appointment only. Please contact us to schedule an appointment. Thank you!

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Serving the needs of homeless companion animals in Dunn County, Wisconsin | State of Wisconsin licensed and inspected: 267328-DS

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