North Platte Animal Shelter Application

NAME OF ANIMAL YOU WISH TO ADOPT:
Full Name

First NameLast Name
Spouse/Significant Other's Full Name

First NameLast Name
E-mail
What is your birthday?

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Your Place of Employment and Occupation
Spouse's Place of Employment and Occupation
Skip if not applicable.
Personal Reference #1 (non family member)

Name of ReferenceRelationshipPhone Number
Personal Reference #2 (non family member)

Name of ReferenceRelationshipPhone Number
Household Information
Do you live in a:
Do you:
If you rent, are pets allowed?
If you rent, what is your landlords info? We will contact them to confirm pets are allowed.

NamePhone Number
Is your current home: (we ask this mostly to help determine if multi pet households have enough space for the pet you are applying for)

Other
How long have you lived at your current residence?
Do you have any plans to move? If so, when?
If you move, what will you do with your animals?
How many adults are in your home?
How many children are in your home?

Number of childrenAges of children
Do you have a fenced yard?
If fenced, please list what type and height. (Example: Chain Link, 4 foot or Privacy, 6 foot, etc.)
Have allergies to animals ever been a problem to any household members?
If allergies arose, what would you do?
Do all family members know about, and approve of adopting a pet?
What is the noise/activity level of your home?
Pet History
Do you own other pets?

Yes or NoTotal number of animals
Are your pets current on vaccines?
Are you dog current on heartworm test and prevention?
If you have cats, do they go outside?

Other
If you have cats, are they declawed?

Other
Animal #1 - What is their name, breed, gender, age, are they spayed/neutered and how long have you owned this pet?
Animal #2 - What is their name, breed, gender, age, are they spayed/neutered and how long have you owned this pet?
Animal #3 - What is their name, breed, gender, age, are they spayed/neutered, and how long have you had this pet?
Animal #4 - What is their name, breed, gender, age, are they spayed/neutered, and how long have you had this pet?
Animal #5 - What is their name, breed, gender, age, are they spayed/neutered, and how long have you had this pet?
Do you have more than 5 pets? This does not disqualify your from adopting.
Have you had other pets in the last 5 years? If yes, what happened to them?
Have you ever had to give up a pet for adoption? If yes, please explain.
Are the current pets in your home familiar/socialized with the type of pet your applying to adopt?
Example: Has your dog been around cats? Has your cat been around dogs? Has your cat been around other cats? Etc.
Pet Information
Will someone be home with the pet during the day?
What is the greatest number of hours the pet will spend alone during the given times?

Day TimeNight Time
Where will the pet spend most of his/her time?

Other
Where will your new pets sleeping quarters be?

Other
Is there someone home at night?
Do you plan to travel with your pet?
If not, where will the pet stay when you are away?
What types of activities do you plan for you and your pet?
If you are planning to adopt a cat, do you plan to declaw him/her? If yes, we do have a No Declaw Policy, if so this would end the application process. We have a strict No Declaw Policy.
Are you planning to allow the cat to go outside?
More Information
Have you ever adopted from a shelter rescue before? If so, what shelter or rescue and when?
Under what circumstances might you decide not to keep a pet?

Other
What is your past experience with dogs? (If applying for a cat, skip this question.
If you have had a special needs dog in the past, what needs did they have? (Blind, deaf, unsocialized, illness, etc.)
What is your past experience with cats? (If applying for a dog, please skip this question)
If you have had a special needs cats in the past, what needs did they have? (Blind, deaf, unsocialized, illness, etc.)
How much do you think this pet will cost you each year? (Please consider their food, vet visits, flea/tick/heartworm control, toys, grooming, etc.)
We want our shelter pets to have forever homes. Some pets have a tougher time transitioning than others. (Examples may be: chewing or unwanted behavior, marking, cat scratching, longer time getting along with other pets in household, etc.) What steps do you plan to take to ensure that the pet stays with your forever and not just 'until'?
Please tell us why you are interested in adopting this particular pet. What drew you to him/her? Why do you think you should be his/her forever family? Pretend I have the winning lottery ticket in my hand - convince me why you should get it 😊
Photo Submissions.

These are extremely helpful, especially if you aren't local.
Feel free to upload any pics of your pets, home or anything you feel might be an asset to your application

Browse Files

Cancelof
Feel free to upload any pics of your pets, home or anything you feel might be an asset to your application.

Browse Files

Cancelof
Feel free to upload any pics of your pets, home or anything you feel might be an asset to your application.

Browse Files

Cancelof
Feel free to upload any pics of your pets, home or anything you feel might be an asset to your application.

Browse Files

Cancelof
Feel free to upload any pics of your pets, home or anything you feel might be an asset to your application.

Browse Files

Cancelof
Would you need transport for this pet?
Is there anything not mentioned that you would like us to know or that we should know?
Veterinarian Information
Name & Info of your current veterinarian:

Name of Veterinarian Clinic

Address of Veterinary Clinic

Name of VeterinarianCity/State

Phone NumberCountry
May we contact your veterinarian for reference?

Other
...you're almost finished!

Please read these statements carefully and initial each if you agree.
Entering your name here is proof of signiture that you understand the application and have completed it to the best of your ability.

First NameLast Name
Date of application

MonthDayYear
Should be Empty:

Household Information

Pet History

Pet Information

More Information

Photo Submissions.

Veterinarian Information

...you're almost finished!