Application for Assistance
Note: Please complete this application to the best of your ability. All information must be complete and accurate and does not guarantee approval. Your application will be reviewed and we will contact you within 5-7 business days - unless it is an urgent request.
Name
*
First Name
Last Name
Email
example@example.com
Street Address
*
City
*
State / Province
*
Postal / Zip Code
*
Phone Number
*
-
Area Code
Phone Number
What are you needing assistance for? (Check all that apply)
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Spay/neuter of an owned dog(s)
Spay/neuter of an owned cat(s)
TNR (trap/neuter/return) of a community cat(s)
Pet food
Emergency medical for low income families with pets
Other
None of the above
Please list total # of members of your household and total annual household income
*
Do you have a working vehicle to help get your pet(s) to their appointments?
*
Please list the following information for each pet: Name, breed, age, weight (best guess) and if they are spayed and neutered.
How much are you able to pay toward the surgery and rabies vaccination? Note: Cat fees at the Sedalia Spay and Neuter Clinic are $65 and there will be a co-pay due for dogs thru the AnimalKind grant.
*
How did you hear about Meow Mission?
*
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Month
/
Day
Year
Date
I understand that by submitting this request for help that we expect for all dogs and cats in your household (or colony cats) to be fixed. Our mission is to spay and neuter and prevent the overpopulation of pets. We have resources that will help pay for it. I understand that by signing this, I am being truthful about the information I provided above and understand that I will not receive food or other services without all of my pets fixed. Please initial.
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