Adoption Application

    Animal Information

    Gender (required)
    MaleFemale

    Adopter Information

    Is this your mailing address? (required)
    YesNo

    Housing

    Do you rent or own? (required)
    OwnRent

    Family Information

    The primary caregiver of this pet is best described as (check all that apply)
    RetiredStay at home/Work from homeEmployed part timeEmployed Full timeCollege studentChild/AdolescentOther

    Does anyone in the home have known pet allergies?
    YesNo

    Veterinary Reference

    Pet Ownership History

    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.

    Spayed/Neutered?
    YesNo

    Spayed/Neutered?
    YesNo

    Spayed/Neutered?
    YesNo

    Spayed/Neutered?
    YesNo

    Spayed/Neutered?
    YesNo

    Please describe the pets you have owned or cared for in the last ten years. Please include name, the type of pet, breed, age, whether it was spayed or neutered, and how long you owned it.

    Spayed/Neutered?
    YesNo

    Spayed/Neutered?
    YesNo

    Spayed/Neutered?
    YesNo

    Spayed/Neutered?
    YesNo

    Spayed/Neutered?
    YesNo

    Have you ever sold, rehomed, or surrendered a pet?
    YesNo

    Adopter Information

    This pet will primarily be
    IndoorsOutdoorsBoth

    What will happen to this pet if:

    Do you plan on declawing?
    YesNo

    Are you prepared for a 15-20 year commitment to a cat?
    YesNo

    Certification

    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.

    Do not send me email updates