Adoption Application

Animal Information

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Adopter Information

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Home phone number is a 10 digit field, including area code.
Cell phone number is a 10 digit field, including area code.
Work phone number is a 10 digit field, including area code.
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Veterinary Reference

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Vet phone number is a 10 digit field, including area code.

Current Pets

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Please describe the pets currently residing in your household, including those cared for by relatives and/or roommates. Please include name, the type of pet, breed, age, whether it is spayed or neutered, and how long you have owned it.
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Pet History

Please describe your previous pets. Please include name, the type of pet, breed, why you no longer have the pet, and whether it was spayed or neutered.
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Continued Care Information

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What will happen to this pet if:
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Certification

Antispam
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By clicking on the Submit button, I certify the information provided on this application is true to the best of my knowledge. I understand that submitting this application does not guarantee I will be able to adopt an animal from the Humane Society of Midland County.