First Name:                                       Last Name:    

    Address:                                           City:                       

    State:              State Arizona Arkansas California Colorado Florida Georgia Louisiana Kansas Kentucky Nebraska Nevada New Hampshire New Mexico New York North Dakota Maine Michigan Minnesota Missouri Montana Ohio Olklahoma Oregon Pennsylvania Rhode Island South Dakota Texas Tennesse Virginia Washington West Virginia Wyoming                                          Zip Code:      

    Phone                                               Email:             

    I Prefer to be contacted by   Please Select Phone Email

   Are you under 18 or older?  Please Select Yes No       If under 18 we will need to contact a parent/guardian for verbal confirmation.

General Rat Info

   Rats up for adoption:     0 1 2 3 4 5                 

   Breed of Rat:         Please Select Blue Dumbo Naked Unsure                           Color            Please Select Blonde Brown Dark Brown Hooded Light Brown Hooded White Unsure

   Has that rat been seen by a veterinarian?        Please Select Yes No

   It is advised to provide the living quarters of the rat.  Will you provide the living quarters?      Please Select Yes No

   Any Medical Concerns that we should be aware of:

   Reason why you would like Rat Finx Rat Rescue to adopt your rat/s

If you would like to help provide nutrition, medical, and shelter for the Rats.                       

If you would prefer in sending supplies needed, please contact us by email and we will set up arrangements.