Dog Adoption Application

Please use the following format 248-555-1212
Please make sure to enter this correctly, as this is the main way we will contact you
Please use the following format 248-555-1212




Current Pet Info

References

If you have never owned a pet please tell us where you would go.
Again if you have never owned a pet, please list where you would go

Please carefully read the following policies. Signify your agreement to adhere to them by signing below.

I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way.
I understand that omission of information and/or failure to answer all questions truthfully can result in this application being denied.
I understand and accept that if an omission or untruth is discovered after an adoption takes place, Midwest Pet Refuge has the right to annul the adoption agreement and repossess the adopted pet.

I understand that Midwest Pet Refuge reserves the right to refuse the adoption of any animal to anyone for any reason, and that all Adoption Fees and Donations are non-refundable.

I give Midwest Pet Refuge permission to investigate all information provided, as well as contact veterinarians, landlords, references and related officials.

I understand that Midwest Pet Refuge makes every effort to place healthy animals, but that they cannot guarantee the health, breed, age or temperament of any animal, and by signing I agree that Midwest Pet Refuge shall not be held responsible for any injuries, property damage, medical, veterinary or other expenses which may be incurred after adoption.

I understand that I am responsible for and financially prepared to provide proper shelter, sufficient high quality food, water and all necessary medical treatment for this pet, including the following: vet recommended vaccinations, flea control, vet care for unexpected injury/ illness, etc. in order to keep this animal healthy and comfortable as an indoor pet. If this is not done, I understand that the Midwest Pet Refuge has the right to repossess the animal.

I understand that if I ever cannot properly care for/ have to give up this animal, it MUST be returned to Midwest Pet Refuge.
If this is not done, I understand that Midwest Pet Refuge has the right to reclaim the animal.

I agree to never harm or abuse the adopted pet in any manner.

Check all entries for accuracy, then press the "Submit" button ONLY ONCE.
If you do not receive a confirmation email after you hit Submit, please re-submit your application.