MCPS Adoption Application Form

This application must be filled out in its entirety to be considered for adopting. False or incomplete applications will be considered null and void. We reserve the right to decline any app.

Application Info:

Animals will not be adopted to anyone under the age of 18 years old.
A background check will be performed on all residents 18 years and older.
Filling out an application does not guarantee adoption approval. We reserve the right to deny any application.
All meet & greets and adoptions take place at Lil' Pear Tree, 702 S. Saginaw Rd Midland, MI.
The adopter is responsible for any expenses related to travel.
When adopting a dog, all other dogs in the home must attend the meet & greet to ensure compatibility.
Applications are processed in the order they are received.

Vetting History Check:

Our application department will contact your current and/or recent veterinarian(s) to obtain vetting history.
- All current and recent pets must be spayed/neutered, consistently kept up to date on vaccinations, HW tested annually with consistency and on HW Preventative at least 6 months out of the year with consistency.

Special Requirements:

If any pets have any special requirements, like a fence or medication they're currently on, that will be discussed early on in the application process.

Today's Date*

Pet's name you're applying for*

Full Legal Name (First, Middle, Last)*

Date of Birth*

Physical Address (PO Boxes are not accepted)*

Street Address

Street Address Line 2

CityState

Postal / Zip CodeCountry

Email Address*

Please enter a valid Email

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

I agree if for any reason, I am unable to care for or keep the above animal, he/she will be returned to Midland County Pit Stop of Midland MI. *

**Please Read and Initial**

Spay/neuter date is scheduled at an approved vet of Midland County Pit Stop and is non-negotiable. I understand the date needs to be kept by the adopter and the adopter is responsible for transporting to and from and any travel, expenses, etc. No exceptions. *

**Please Read and Initial**

Number of adults living in your household *

Number of children in your household *

Spouse/Roommate's name (First, Middle, and Last)*

Spouse/Roommate's Date of Birth*

Please list anyone else, 18 years or older, who lives in your home (first, middle and last name) and date of birth*

I give Midland County Pit Stop permission to do background checks on all adults, 18 years and older, in the home. **PLEASE INITIAL***

RentOwn

If you rent, please indicate your Landlord's Name or Property Management. We will contact them to verify pet policies. If this does not apply, please indicate N/A in the rental questions

Landlord or Property Management's Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

How long have you lived at this address?*

CitySuburbRural

YesNo

Is the yard fenced? If so, how high is the fence? Please note some dogs may require a fenced yard but not all do. The interviewer can make sure you are aware of any requirements*

I am aware virtual home visits are required prior to adoption approval and placement by an Adoption Liaison. *

**Please Read and Initial**

YesNo

Dog FriendlyCat FriendlyChild Friendly

Are there specific breeds you prefer or have experience with?

What hours is the primary caretaker typically at home?*

YesNo

Are there medical reasons your pet has not been vaccinated or on preventatives regularly and consistently? (This will be confirmed by your vet during the vet check.)*

Please list all pets in the last 5 years, including name, age, breed/mix, veterinary contact information, spayed/neutered, UTD vaccinations, annual HW Test and monthly HW Preventative. Please provide complete information.*

YesNo

If yes, please explain:

Tell us about your experience with pets

Where will you vet your new pet? (Name and Phone Number)

I give Midland County Pit Stop Permission to check with previous and current veterinarians prior to adoption approval and placement by an Adoption Liaison. I agree to contact all previous and current veterinarians and give permission for Midland County Pit Stop to call. *

**Please Read and Initial**

IndoorOutdoorBoth

Where will your new pet stay when you are home?*

Where will your new pet stay when no one is home?*

How many hours a day will your pet be home alone?*

Where will your new pet stay when you're out of town or on vacation?*

In the event the main caretaker is unable to care for the pet, what are your plans for the pet?*

If you do not have other pets, how will you socialize your new pet?*

Once your pet is deemed adoptable by the Adoption Liaison, you may begin the adoption process. **PLEASE INITIAL***

PERSONAL OR PROPERTY DAMAGE AND/OR INJURY I acknowledge and agree that if the animal bites or otherwise injures humans or other animals, I will not hold Midland County Pit Stop 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 in Midland, MI will not be responsible for any damage the adopted 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, and no attempt 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, judgments, claims and demand of any nature whatsoever arising out of my adoption of a pet from Midland County Pit Stop.

**Please Read and Initial**

I understand that if I am approved as an adopter 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 Read and Initial**

I understand adoption fees are non-refundable.

**Please Read and Initial**

Midland County Pit Stop board requires one signature on all foster and adoption applications. It is understood by the board that this singular signature will cover the entire household at the time of signing. However, ultimately the main point of contact and the responsible party is the individual signing the required documentation.

**Please Read and Initial**

MCPS Pet Adoption Application

Our Pet Adoption Policy

Pet Adoption Fees

Applicant Information

Home/Family Information

Current/Previous Pet Information

Veterinarian Information

New Pet Care Plan

A signature will be required upon approval of application. Please note that you will be contacted from our application processor by email or text.

Please call or text 989-948-1096 to confirm we have received your application. Applications are processed in the order received.