Pet Spay/Neuter Voucher

Requested By*

First NameLast Name

Thanks to a grant from the Eugene and Marlaina Johnston Charitable Foundation, FOCCAS is able to provide vouchers to help low income families to pay for their pets to be spayed or neutered at a partnering Spay/Neuter Clinic. There is a now a limit of FIVE vouchers per household per year. These are for personal pets ONLY. You cannot apply on behalf of someone or for a pet that is not your own. Unused vouchers are not transferable if you decide to rehome the pet.

Animals must be younger than 7 years and have both testicles present at time of neuter. Cryptorchid (only 1 testicle dropped) male cats/dogs will be turned away at vet visit. You must fill out your voucher(s) at least 7 days prior to your S/N appointment.

The cost will be:

	Cats	Dogs Weight 0-49lbs	Dogs Weight 50-75lbs
Male	$60	$100	$120
Female	$90	$115	$125

and must be paid to FOCCAS prior to the appointment being made.

Spay/Neuter Payment Link - Please put in the accurate amount for surgery in the DONATION AMOUNT line and your name, pets name and/ or voucher reference number in the memo area. This will allow for you voucher to be activated.

You will need to fill out a separate form for EACH PET.

Home Address (no P.O boxes)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Email*

example@example.com

Type of pet*

DogCat

Sex*

MaleFemale

Pet's name*

Age of pet*

Approximate WEIGHT of pet*

Describe pet (color, breed, hair length)*

This is to confirm that you understand this voucher is ONLY to be used at an assigned FOCCAS approved Spay/Neuter Clinic. The following Email will be your voucher reference number and will only be usable once the payment is made to FOCCAS via Link Below. There is a now a limit of FIVE vouchers per household per year.*

Yes, I understand

DateTime

Please Submit Payment for Spay/Neuter Here.

Spay/Neuter Payment Link

-Please put in the accurate amount for surgery in the DONATION line and your name, pets name and/ or voucher reference number in the memo area. This will allow for you voucher to be activated.

We will call you to schedule an appointment