Adoption Form

If you are interested in adopting a dog or cat you will need to complete the application below:




Are you interested in adopting a Cat or Dog



What is the name of the pet you are interested in adopting?



Your Name



Phone



Address



City


State


Zip


Email


Age of the person applying to adopt


Current Employer with Address and phone number


Would you like to receive emails of upcoming events?

Check to Receive Emails


How did you hear about York Adopt-A-Pet?


Type of residence:


Other (explain):


Do you own or rent:



How long have you lived at this residence?


Landlord's Name:


Landlords Phone:


Number of adults in the home:


Number and ages of children in the home:


Have you adopted from us before?



If yes, when/whom?



Who will be the primary caregiver for your new pet?



How much one-on-one time do you plan on spending with your new pet?



Walking/Exercising:



Do you have any other pets?


If yes, list number and type:



Who is your current vet?



Your Vets Address & Phone:



Are your pets spayed/neutered?


Have you ever owned a cat, dog, or rabbit before?



Why do you want this particular animal?


How will you correct your animal if it misbehaves?



What behaviors do you find unacceptable in pets?

Have you ever relinquished an animal?



If yes, to whom & reason



For what reason would you surrender an animal?



For adopting a dog, do you have a completely fenced yard? What Type and How High

For adopting a cat please enter N/A



Do you plan on declawing, removing dewclaws, or any other altering of your new pet?



What is the longest period your pet will be left alone?



Are all members of your household in favor of adopting a pet?



List one person for reference



Relationship of reference



Phone for reference



By submitting this form, I certify all the information I provided is true. I understand giving false information is grounds for denying my application. I understand that in some cases a home check or verification of residency may be mandatory prior to the animal’s adoption. I understand and agree YAAP may demand the return of the animal for any violation of the terms of the adoption contract and agreement.


You accept these terms by placing your name below:



Date Submitted



When you submit your application you will be redirected to a Thank You page. If this does not happen then all the required fields are not completed. Please review and the incomplete fields will be highlighted in yellow




1511 N Platte Ave

York, NE 68467

Shelter 402.362.3964


Dog Info: Kim 402-366-2424 or Email kim@yorkadoptapet.com


Cat Info: LaMoine Email lamoine@inebraska.com 402-366-0533 or  Noelle email noelle@yorkadoptapet.com 402-710-8598


YAAP is open to the public from 12 noon to 3 pm Tuesday through Saturday