2025 adoption application draft

Do you already have a pet in mind? List the name(s) and ID number(s) below. If not - don't worry, we'll help find you a match. (Maximum response 255 chars, approx. 5 rows of text)

Your Information

Field Is Required First

Field Is Required Last

Field Is Required Date of Birth:

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:

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

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

Keep me logged in. What's this?

Preferred Name (Maximum response 255 chars, approx. 5 rows of text)

Are you a U.S. Military Veteran?

Your Home & Compatability

Field Is Required Do you have any pet ownership or breed restrictions where you live?

Tell us a little bit about your current household (check all that apply).

We have one or more dogs
We have one or more cats
We have animals other than cats and dogs
We have children or children frequently visit our home
We enjoy entertaining and/or have friends or family frequently visiting

How would you describe your household on most days?

Active, fun, always something going on
Fun, mellow, but not too quiet
Chill, quiet and relaxed

On a scale of 1 (completely new) to 10 (expert), how would you rate your experience for caring for this type of animal?

Pets provide companionship in so many ways. Select what you're looking for in a new dog (choose as many as you'd like)

A family companion who enjoys spending time at home together
An adventure buddy, who loves spending time outdoors
Goes with the flow, equally happy being active or hanging out at home
An activity partner who loves playing and learning new things
I want a friend for my current pet(s)
I want to save a life by helping an animal in need
Other

Other (please describe) (Maximum response 255 chars, approx. 5 rows of text)

Resources

We have great resources to set your new relationship up for success. What would you like to know more about?

How to welcome your new dog to your home
Crate training
How to introduce a dog to babies or young children
How to introduce a dog to other dogs
How to prepare for a puppy
Community Resources (Pet Food Pantry, Animeals, vaccination clinics, etc.)
Fence resources
All of the above
No thanks

Additional Information

Is there anything else you'd like to tell us about yourself, the pet(s) you're interested in adopting or your home environment? (Maximum response 255 chars, approx. 5 rows of text)

I understand this is an application only and the Nebraska Humane Society has the sole discretion, with or without cause, to accept or decline this application.

Print your name below to act as a signature

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

Rating scale test

1
10

Numeric Value test

2025 adoption application draft

Your Home & Compatability

Resources

Additional Information

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