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Dog adoption application

Thank you for applying! This is an exciting first step to adding to your family! Keep an eye on your inbox (and your spam folder) for updates on your application.
You do not need to wait for approval to come to the shelter! In fact, we prioritize applications for people who are in the building. Remember that the pets are adopted on a first-come, first-served basis, so getting here early is advised.

1. Applicant information

Field Is Required First

Field Is Required Last

Field Is Required Date of Birth:

Field Is Required Street 1:

Street 2:

Field Is Required City/Town:

Field Is Required State / Province:

Field Is Required ZIP / Postal Code:

Field Is Required Email:

Field Is Required Phone Number:

If you respond and have not already registered, you will receive periodic updates and communications from Nebraska Humane Society.

Yes, I would like to receive postal mail from Nebraska Humane Society

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2. Field Is Required Is this the first online application you have submitted for this type of animal?

3. Field Is Required Do you own or rent your home? If you rent or are not the owner of the home, please list the owner or landlord's contact information and the name of the apartment complex (Maximum response 255 chars, approx. 5 rows of text)

4. Field Is Required Does your home have a fenced in yard? If so, what type of fence and how high is it? (Maximum response 255 chars, approx. 5 rows of text)

5. Field Is Required How many adults live in your home? (Maximum response 255 chars, approx. 5 rows of text)

6. Field Is Required List the ages of any children with which the animal will have regular contact. How frequently will they be in contact? (Maximum response 255 chars, approx. 5 rows of text)

7. Field Is Required On an average day, how many hours at a time will the animal be left alone? (Maximum response 255 chars, approx. 5 rows of text)

8. Field Is Required Please list any cats, dogs, or other animals in the household. Include the type/breed of animal, age, sex, and whether or not they are spayed or neutered. (Maximum response 255 chars, approx. 5 rows of text)

9. Field Is Required Have you owned dogs in the past? If so, tell us about with what kinds of dogs (breed, size, age, etc.) you have experience. (Maximum response 255 chars, approx. 5 rows of text)

10. Field Is Required Describe the type of dog you are interested in adopting. If you are applying for a specific dog, please include their identification number. (Maximum response 255 chars, approx. 5 rows of text)

11. Are you a U.S. Military Veteran?

12. Field Is Required How did you hear about adoption? (Select one of the available choices or enter a different value.) How did you hear about adoption? Click this to indicate that you will select an existing value. Tab to next input." How did you hear about adoption? How did you hear about adoption? Click this to indicate that you will enter a new value. Tab to next input." How did you hear about adoption? Provide your answer here

Due to animal requirements and adoption criteria, this does not guarantee that you will be approved for these specific animals, but it gives us a general idea of the type of animal you are interested in.

Dog adoption application

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