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Critter adoption application

You will be contacted via e-mail regarding your application, so please monitor your inbox and check your spam folder as well. If we have additional questions, we may contact you via telephone as well. All of the animals are adopted out on a first-come, first-served basis.

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

Keep me logged in. What's this?

2. Preferred Name

3. Is this the first online application you have submitted for this type of animal?

4. Field Is Required Have you owned this type of animal in the past? If so, tell us about your experience. (Maximum response 255 chars, approx. 5 rows of text)

5. Field Is Required Do you already have a habitat available for this animal? (Maximum response 255 chars, approx. 5 rows of text)

6. Field Is Required List the critters with which you are interested. Please include their identification numbers if possible. (Maximum response 255 chars, approx. 5 rows of text)

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.

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

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

Critter adoption application

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