MIDLAND COUNTY PIT STOP
Home
About
Adopt Me!
K-9
Feline
Forms
I Want to Adopt
I Want to Foster
Find a Foster for My Pet
I Want to Help!
Surrender My Pet
Donate
CommUnity
Contact
K9 Katwalk 2023
Midland County Pit Stop Foster Application
*All approve fosters will be required to complete and adhere to our foster contract which will be sent to you once you're approved to foster.
*Foster's transport help is needed to complete vetting (in Midland, MI) and spay/neuter (in Mt. Pleasant or Clare, MI)
*
Indicates required field
Date
*
Foster Applicant Information
Name: First, Middle, and Last
*
Birthdate
*
Physical Address
*
City
*
State
*
Zipcode
*
Most Recent Previous Address
*
City
*
State
*
Zipcode
*
Day Phone
*
Cell Phone
*
Email
*
References
Please provide three references who are not considered family or living with you.
First and Last Name
*
Phone Number
*
First and Last Name
*
Phone Number
*
First and Last Name
*
Phone Number
*
Current/Previous Pet Info
Have you ever owned a dog or cat?
*
Do you currently have pets?
*
Yes
No
Type/Breed/Name/Age/ Veterinarian/Spay/Neuter/UTD
*
Home/Family Information
Number of adults living in your household?
*
Number of children in your household?
*
Spouse/Roommate's Name (First, Middle, and Last)
*
I give Midland County Pit Stop permission to do background checks on all adults in the home. ******PLEASE INITIAL******
*
Birthdate of Spouse/Roommate(s) living in the house
*
Do you rent or own?
*
Rent
Own
If you rent, please list your landlord's first and last name
*
Landlord's Phone Number
*
Which best describes the area you live in?
*
City
Suburb
Rural
How long have you lived at this address?
*
Do you have a yard
*
Yes
No
Is it fenced? If so, how high is the fence?
*
Primary Pet Caretaker is
*
Employed Full Time
Employed Part Time
Retired
Stay at home or work from home
Student
Other - please specify
*
In the event the main caretaker is unable to care for the foster pet, Midland County Pit Stop should be contacted to make other arrangements. **** PLEASE INITIAL ****
*
Date
*
Do any of your household members suffer from pet dander related allergies?
*
Yes
No
Does the foster pet need to be
*
Dog friendly
Cat friendly
Child friendly
Are there any specific breeds, weight limits or sizes you prefer to foster?
*
Care Plan
Comment
*
If you do not have other pets, how will you socialize the foster pet?
*
How many hours a day will the foster pet be alone?
*
Where will the foster pet stay when no one is home?
*
Where will the foster pet stay when you are home?
*
Will this pet be kept
*
Indoor
Outdoor
Both
When going out of town or on vacation, Midland County Pit Stop must be given notice in advance to make arrangements for the foster pet. ** PLEASE INITIAL **
*
Date
*
Home visits are required prior to foster approval and placement by a foster liaison. ** PLEASE INITIAL **
*
Date
*
Veterinary Care
Where will you vet your foster pet?
*
Are your current pets on preventatives?
*
Yes
No
Tell us about your experience with pets
Comment
*
.
**
If for any reason you are unable to care for the foster animal, contact Midland County Pit Stop. *
** PERSONAL OR PROPERTY DAMAGE AND/OR INJURY** I acknowledge and agree that if the 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 foster pet 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 foster pet from Midland County Pit Stop. I understand that if I am approved as a foster to a pet, I must abide by this agreement and that this agreement applies to any and all dogs/cats that I foster from Midland County Pit Stop. ********************PLEASE INITIAL********************
*
Date
*
** Signature will be required upon approval of application **
Approved By (Midland County Pit Stop Foster Liaison)
*
Date
*
Submit
Date
APPROVED BY (Midland County Pit Stop Liason)
Home
About
Adopt Me!
K-9
Feline
Forms
I Want to Adopt
I Want to Foster
Find a Foster for My Pet
I Want to Help!
Surrender My Pet
Donate
CommUnity
Contact
K9 Katwalk 2023