MIDLAND COUNTY PIT STOP
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Midland County Pit Stop Pet Adoption Application
1.) This application must be filled out in its entirety to be considered for potential adoption.
2.) Animals will not be adopted to minors under 18 years old.
3.) False or incomplete applications will be considered null and void.
4.) Our Application Dept. will be contacting your current/recent vet(s) and asking for vetting history. We require all current and recent pets be spayed/neutered, current and recent pets must be vaccinated and have been consistent on them. We require annual Heartworm Testing and that the current and recent pets by on HW Preventative consistently.
5.) A background check will be performed on all residents in the home 18 and older.
6.) Some pets may require a fenced in yard and that will be discussed early in the process of an application.
7.) It is important that a pet and the new family be a match in temperament, activity level and family dynamics and we strive to make sure that occurs.
8.) Filling out this application does not guarantee an adoption is approved. We reserve the right to deny any application.
9.) All meet & greets and adoptions are done in MIdland, MI. Adopter is responsible for any travel expenses incurred.
10.) When adopting a dog, your other dogs must come to the meet & greet as well so we know all dog are compatible.
Adoption Fees are as follows:
Dogs 8 weeks to 2 yo $350.00
Dogs 2 - 5 yo $300.00
Dogs over 5 yo $250.00
(1) Cat/kitten $135.00
(2) Cats/kittens
adopted same day $175.00
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Indicates required field
Today's Date:
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Pet's Name You're Applying For:
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We are having issues receiving apps. Please review the app and call or text 989.948.1096 to set up a time to submit an app by phone. You may also send answers to the app questions to
[email protected]
sorry for the inconvenience
Adoption Applicant Information
Full Legal Name: First, Middle and Last
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Date of Birth
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Physical Address ( PO Boxes are not accepted)
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City
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State
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Zip Code
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Previous Address
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City
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State
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Zip Code
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Day Phone
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Cell Phone
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Email
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Current/Previous Pet Info
Have you ever owned a dog or cat?
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Yes
No
Do you currently have pets?
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Yes
No
Please list all pets in the last 7 years. Include pet name, age, breed/mix, Veterinarian Contact info., S/N, UTD on vaccinations, Annual HW Test and Monthly HW Preventatvie HW
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Home/Family Information
Number of adults living in your household
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Number of children in your household
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Spouse/Roommate's Name (First, Middle and Last) and Date of Birth
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Please list anyone else, 18 or older, who lives in your home, first, middle and last name and date of birth
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I give Midland County Pit Stop permission to do background checks on all adults, 18 and older, in the home. ******PLEASE INITIAL******
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Do you rent or own?
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Rent
Own
If you rent, indicate your landlord's name or Property Management. We will make contact to verify pet policies. If this does not apply indicate "NA" in the rental questions
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Landlord or Property Management's Phone Number
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Which best describes the area you live?
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City
Suburb
Rural
How long have you lived at this address?
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Do you have a yard?
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Yes
No
Is it fenced? If so, how high is the fence? Please note some dogs may require a fenced yard but not all do. Interviewer can make sure you are aware of any requirement
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Primary Pet Caretaker is
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Employed full time
Employed part time
Retired
Stay at home or work from home
College Student
Check all that apply
Other - please specify
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What hours primary caretaker is home
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In the event the main caretaker is unable to care for the pet, what are your plans for the pet?
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Do any of your household members suffer from pet dander related allergies?
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Yes
No
Do you need your pet to be
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Dog Friendly
Cat Friendly
Child Friendly
Are there specific breeds you prefer or have experience with?
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Care Plan
Will this pet be kept
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Indoor
Outdoor
Both
Where will your new pet stay when you are home?
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Where will your new pet stay when no one is home?
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How many hours a day will your pet be alone?
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Where will your new pet stay when you are out of town or on vacation?
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If you do not have other pets, how will you socialize your new pet?
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Virtual home visits are required prior to adoption approval and placement by an adoption liaison. **PLEASE INITIAL**
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Veterinary Care
Vet Checks are part of our application process. All current and recent pets in the home must be spayed/neutered, vaccinated annually and consistently, HW tested annually and on monthly HW Preventative.
Where will you vet your new pet? If you are not currently established with a vet, once approved and prior to adoption, applicant make appointment with the prefererred Vet and give them permission to confirm with our Adoption Liaison.
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Are current pets and were recent/past pets up to date (UTD) on vaccinations and vaccinated consistently? (Rabies, required by Michigan State Law and Distemper)
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Yes
No
Are current pets and were recent/past pets tested annually for Heartworm?
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Yes
No
Are current pets and were recent/past pets on consistent monthly Heartworm Preventative?
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Yes
No
If you have vetted at multiple locatations with current or recent pets, please create a timeline
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What is the name of the vet you are currently established with
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Are there medical reasons your pet has not been vaccinated or on preventatives regularly and consistently? (this would need to be confirmed by your vet during the vet check)
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Have you ever surrendered a pet to Animal Control, Humane Society, Shelter, Rescue or individual?
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Yes
No
If Yes, please explain
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Once an application to adopt a pet is approved by the Adoption Liaison, a meet & greet will be arranged. *****PLEASE INITIAL*****
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**If for any reason you are unable to care for or keep the adopted animal, contact Midland County Pit Stop. **
PERSONAL OR PROPERTY DAMAGE AND/OR INJURY I acknowledge and agree that if the adopted animal bites or causes other injuries to humans and other animal, I will not hold Midland County Pit Stop of Midland Michigan responsible. I understand that all animals can carry and transmit diseases, including zoonotic diseases that can be transferred from animals to humans. I understand that Midland County Pit Stop will not be responsible for any damage the adopted animal may inflict on another person, another animal or any property, or for the transmission or transfer of any disease or parasite to other animals or people in the household. No attempt(s) will be made by me or anyone on my behalf to hold Midland County Pit Stop responsible. I hereby release Midland County Pit Stop and its agents, representatives/liaisons, and volunteers, and agree to indemnify and hold same harmless from any and all actions, causes of action, suits, debts, dues, accounts, covenants, agreements, judgements, claims and demand of any nature whatsoever arising out of my adoption of a pet from Midland County Pit Stop. I understand that if I am approved as an adoptee to a pet, I must abide by this agreement and that this agreement applies to any and all dogs/cats that I adopt from Midland County Pit Stop. *****PLEASE INITIAL*****
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Adoption fees are non-refundable. ****PLEASE INITIAL****
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** A Signature will be required upon approval of Application**
Please note that you will be contacted from our application processor by email.
Signature
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Date
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APPROVED BY (Midland County Pit Stop Foster Liaison)
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Date
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Submit
Please call or text 989.948.1096 to confirm we have received your application. Applications are processed in the order received.
Home
About
Adopt Me!
K-9
Feline
Applications!
I Want To Adopt
I Want to Foster
Find a Foster for My Pet
I Want to Help!
Donate
CommUnity
Wish Lists!
K9 Katwalk 2024
Vet Info!