We appreciate your interest in foster volunteering with Rutherford County Government. The County provides equal and advanced opportunities for all persons regardless of race, creed, sex, national origin, age, religion, disability, marital status or any other classification protected by law.

1. Please enter the following information:
First Name: Last Name: Phone #: Email Address: Home Address:
2. Emergency Contact
First Name: Last Name: Phone #: Relationship:
3. Are you 18 years of age or old?
4. Are you able to perform the essential functions of the foster volunteer position for which you are applying? Either with or without a reasonable accommodation?
5. Have you ever worked/volunteered for Rutherford County Government?
6. Have you ever been discharged or asked to resign from a foster or volunteer program?
7. Have you lived in another state in the last 10 years?
8. Please list total number of children (under 18) in the home & ages of children:
9. Please list type, age and total number of animals currently in the home:
10. Are all cats & dogs up to date on their rabies vaccinations?
11. I am interested in fostering (check all that apply):


12. Do you have experience bottle feeding?
13. If applicable, list other qualifications, experiences, training, etc. related to the foster volunteer position for which you are applying.
14. If applicable, where else have you foster volunteered and what were your duties?
15. Please list references relevant (professional, past or current volunteer coordinator/reference, etc.). Note all references may be contacted.
First Name: Last Name Business/Organization: Business Address: Phone #: Relation/How Long Known: Reason for Leaving:

No References Added
16. Please explain why you are pursuing this foster volunteer opportunity.
17. If selected, when could you begin volunteering?
18. Additional comments? Upload Picture/Scan of Legal Photo ID

Other Documents

Please upload images or docs for all rabies certificates/proof of rabies vaccinations for ALL cats and dogs in the home below. If unable to submit at this time, please email records ASAP to: [email protected] or fax to: 615-898-7994 (“attention to” Foster Coordinator).


I hereby affirm that the information provided on this application is true and complete to the best of my knowledge. I understand that falsified information or significant omissions may disqualify me and my application from further considerations and may be considered justification for dismissal if discovered later.

I waive any right of privilege, privacy, and/or confidentiality I may have in the information provided by references or others whom I have indicated may be contacted. I understand I am applying for a County volunteer opportunity and my application becomes part of public record and may be viewed upon request.

I understand for consideration I may be subject to screening requirements including but not limited to drug screening, background check, reference check, felony search, sex offender search, criminal records check, and fingerprinting. I hereby authorize the County to conduct all inquiries as described to be conducted either pre or post approval for volunteering. I release the County and all providers of information from any liability arising out of the gathering and use of such information. I understand that screening may impact continuation of volunteer opportunities.

I understand that if appointed with the County, I must complete the county required paperwork and screenings before volunteering with the county.

I acknowledge that neither me nor my minor child (as applicable) are employees or any type of agents of Rutherford County, Tennessee and that no such relationship is created by me or my minor child providing volunteer services hereunder.

By signing below on behalf of myself and/or as the parent and/or legal guardian of my minor child, I hereby release, waive, discharge, covenant not to sue, and hold harmless Rutherford County, Tennessee and its employees, officials, agents, and successors and assigns from any and all liability, claims, demands, actions, and causes of action of any nature whatsoever which may arise from the volunteer relationship or services I or my minor child provide hereunder. I hereby expressly assume all risk of injury or harm that may occur to me or my minor child.

Under 18 Parental Consent: If I am signing on behalf of a minor volunteer, I certify that I am the legal guardian of the participant applicant and do therefore give full permission of participation of applicant hereto. My signature below confirms consent to the terms of the confirmations listed above on behalf of my minor child.