Paw Street Application

Application for Pet Care Assistance

Paw Street Inc.
Owner Information*

First NameLast Name
Spouse or Co-Owner

First NameLast Name
Address (If homeless, fill in City and State only) Do not leave Blank

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
(area code) + Phone Number
Email*
example@example.com
Preferred Method of Contact*

PhoneEmail
What is Your Age Group?*

18-35 Years36-59 Years60 Years and Older
Number of Adults Living In The Home*
Number of Dependent Children *
Are you or your spouse/partner employed? *
What is your Monthly Household Income?*
Include wages, spousal income, child support, SSDI, SSI or SS payments, pension.
Has there recently been a major event that has caused loss of income? If Yes, please give a brief description. *
Do You Own or Rent your Home?*

RentOwnOther
Type of Housing*

ApartmentCondoSingle Family ResidencOther
Please let us know if you have plans to move from your current address*

Yes, I plan on moving within 12 months.No, I have no plans on moving.Currently facing eviction.
Which of these government benefits do you currently recieve?*

Food StampsSection 8Utility AssistanceFree Student LunchMedicaidSSDI/SSINONE
Choose how you would like to Pay It Forward*

Volunteer at a local nonprofitHost a Fundraising Event for Paw Street.Become an active Paw Street VolunteerBecome a Paw Street Donor! Small donations grow into big donations.Not interested in Giving Back at this time.
Information About Your Pet(s)
IMPORTANT NOTICE: Paw Street Inc. cannot provide assistance for most life saving emergency situations, especially those that take place after normal business hours and require treatment from emergency pet hospitals, except in cases when euthanasia is required to end a pet's suffering.
How many dogs do you currently own?
How many cats do you currently own?
Indicate how many dogs and how many cats.
How many pets are you seeking assistance for today? *
How long have your pet(s) lived with you? See example text below*
Please include pet name and type of pet. Use the letter Y for years and the letter M for months.
Is the pet up to date (UTD) on Rabies Vaccination?*

Yes, All of my pets are UTDNo, None of my pets are UTDSome but not all of my pets are UTD.
Is your pet Microchipped?

YesNoI am not sure
If your pet is microchipped, what is your pet's Microchip Number?
If you do not know your pet's microchip number, please have it scanned by a local rescue or a Paw Street Volunteer. Paw Street can assist you with registering your pet's microchip if is not already.
Has your pet been spayed or neutered?*

Yes, all of my pets are fixed.No, none of my pets are fixed.Some but not all of my pets are fixed!I do not want to fix my pet at this time.
Who is your pet's veterinarian?*
Enter N/A if you do not have an established veterinarian.
Are you able to provide adequate food for your pet on a regular basis?*
Do you have plans to rehome your pet in the near future?*

NoYesUnsure
What kind of assistance are you requesting for your pet or pets? Include pet names and type of pet that needs assistance. *
How did you hear about us?*

Friend/FamilySocial EventsSocial WorkerInternet SearchSocial MediaAnimal Rescue/ShelterVeterinarianOther
STOP and read the important information below before submitting your application.
PLEASE have all required documents downloaded to your device before submitting this application if possible.

Proof of Household Income and/or Government Benefit received
Photo of State ID
Proof of Pet Ownership- document must contain owner's name and pet information.
Pet Photo

Some additional documents may be requested.
Required documents are listed on our website at https://pawstreet.org

Submitted applications are processed by our caseworkers in the order they are recieved. Make sure to check your email account often for messages from Paw Street and send replies promptly.

A Welcome Message will be sent to the email account listed on the application within 1 to 2 business days after application has been submitted. Please respond promptly to any questions your caseworker may include in this email.

A Request for Documents will be emailed to all pre-qualified applicatants. This email will contain a list of required documents based on each individual's circumstances, along with instructions on how to properly email the documents back to Paw Street. Once documents are requested by caseworker, pet owners must submit all documents, by email, within 24 hours to avoid temporary or final suspension of application.

All correspondance between pet owner and Paw Street must take place in email.
Phone conversations regarding relevent information pertaining to application, financial assistance, vet appointments or pet information will be summerized in a follow up email for future references by both parties.

Paw Street will call to speak with pet owners as part of the application process.

Pet owners that do not respond to emails or phone calls within 24 HOURS will have their case closed.

Please note that Paw Street cannot help everyone. Approval is based on available funds and other factors such as eligibiltiy, probable outcomes and favorability of prognosis.

All STAFF members at Paw Street are volunteers! Please be patient as many of us have other full time jobs, also volunteer for local animal rescues and have families and pets that need our attention as well. We are highly committed to our duties at Paw Street as well as the people and pets we serve.

FALSE INFORMATION given by applicants will result in application for assistance being denied and applicants may be held liable for repayment of all financial assistance provided.

Thank you for your cooperation,
The Paw Street Team
Should be Empty:

Application for Pet Care Assistance

Information About Your Pet(s)

STOP and read the important information below before submitting your application.