KSRF Funding Request Submission Form
Funding Criteria can be found at https://www.ksrf.org funding-criteria. All funding is at the discretion of the KSRF Board.
Your Name (or Rescue Org)
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Dog's Name:
Dog's Age
This Submission is a:
Please Select
Estimate for Prior Approval (large expenses)
Final Veterinarian Invoice
**Please see funding criteria for further information. Reminder that all funding is at the discretion of the KSRF Board.
Amount Being Requested:
*
* There is a $2,000 maximum lifetime funding limit per dog, per the referenced funding criteria linked above.
Description of Request:
Certify to the best of the rescuers knowledge and belief the Kees is a pure bred rescued Keeshond, is currently in a foster home or rescue's direct care and that any false statements are grounds for denial now and in the future.
Upload a copy of the receipts:
*
Upload a File
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Choose a file
Submitted receipts should be free from alternation. Alternations will delay processing time as clarifications will be required.
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of
Upload a photo of the dog
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Message / Additional Info
Reminder that all funding is at the discretion of the KSRF Board.
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