American Humane Second Chance® Fund Application Form

Second Chance® Fund Grant Application

Please note: You have the ability to save your progress by scrolling to the bottom and selecting "Save."
Due to the overwhelming number of abuse cases nationwide, the Second Chance® Fund is offered only in select cases of animal abuse or neglect. Funding is awarded on a case-by-case basis. Selected cases will be used for fundraising purposes by American Humane.

General guidelines of the Fund include:
- Only animal sheltering agencies (public or private) and rescue groups are considered for the Second Chance® Fund.
- Only (i) non-profit companies exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code of 1986 and (ii) local municipal agencies are eligible to apply.
- Funding may be used only to cover medical procedures for animals that have been victims of abuse or neglect and require medical treatment before being placed for adoption. Routine medical procedures -- such as vaccinations, heartworm testing, behavior modification and/or training are outside the scope of this fund. Spay/neuter surgery costs, if listed in the itemized costs of care for a cruelty/neglect case, even if not medically necessary for treatment, are eligible.
- Medical procedures covered under the fund will allow animals to medically recover and live a relatively pain-free life.
- Animals involved can be successfully placed in new homes.
- Funding to any one agency is limited to $2,000 per fiscal year.
- Applications must be received no later than 6 months following the date of intake of the animal(s).
- Only applications received through the appropriate online submission process will be eligible.
Before submitting an application, applicants must ensure that it includes all of the following documents or their request will be considered incomplete and may be denied:
- Copy of 501(c)(3) determination letter
- Completed and signed application
- All itemized veterinary receipts* (must be issued by veterinarian’s office)
- Before and/or after digital photographs of animals
*If services are/were provided by on-staff veterinarian, itemized receipts must reflect out-of-pocket expenses only -- not retail value.
Basic Agency/Organization Info
To qualify for our grants, your agency must be one of the following*

Non-profit 501c(3) (e.g., non-profit agency, animal welfare organization, rescue group)Municipal agency (e.g., animal control; county or city agency)
Upload a copy of your 501(c)3 determination letter (required for non-profits).

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Agency/Organization Name*
Contact Name*

First NameLast Name
Phone Number*
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Facebook Account
Example: www.facebook.com/AmericanHumane
Instagram Account
Example: @AmericanHumane
Animal's Information
Name of animal:*
Age*
Species*
If other, please specify:
Breed*
Type "Unknown" if not known
Gender*

MaleFemale
Spayed or Neutered?*

YesNo
If surgery is pending, please indicate when will it be performed?

MonthDayYear
Date
Upload Before and After photos:*

Ensure the photos are high-resolution.
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Upload any videos (reccomended):

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Provide a link to story shared on agency's social platform (optional):
Provide Facebook or Instagram link.
Incident Information
Date of Incident:*

MonthDayYear
Date
Date you took the animal into custody:*

MonthDayYear
Date
Please explain in detail the extent of the animal’s medical condition and the care needed, including costs:*
Is the animal expected to make a full recovery?*
Has the animal been permanently placed with a new guardian? (If no, please indicate timeline before permanent placement.)*
Please provide a brief history of how you acquired the animal.*
Please provide information on the case and what happened to the animal.*
Please provide general information about the animal’s behavior, personality, and what makes their story so compelling*
Since this is a cruelty/neglect case, has the case been investigated?*

YesNo
If "Yes", please provide details including who is conducting the investigation. If "No", please explain.
Required Documentation
IMPORTANT: Supporting documentation including itemized veterinary bills for all animals must be attached to this application.
Upload itemized veterinary receipts:*

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Other supporting documents:

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Disclosure & Agreement:

By signing below, I agree that I have submitted this application in good faith and that my submission fits the eligibility requirements set for this grant. I indicate by my signature that I understand and agree to abide by the rules, guidelines, and requirements of the grant. I am also aware that incomplete applications and/or the submission of false information may result in my application being denied, and that falsifying information may bar me from future funding opportunities made available by American Humane.

I understand that funding is limited and, therefore, only select applicants will receive grant funding. I agree that I will use the grant funds solely for the purpose described in this application and that I will repay to American Humane any grant funds that I am unable to spend in furtherance of that purpose. Additionally, by signing below, I agree that American Humane, and third parties authorized by American Humane, may publicly disclose information about the award of this grant, including my name, the amount awarded, a description of my animal, biographical and narrative information pertaining to me, my animal and our story, and photos, videos and stories related to the grant for any lawful purpose, in any fundraising appeals, direct mailings, promotions, publications, press releases, social media posts or other public communications in all media without my prior written consent. I agree to provide American Humane with photos, videos and stories of the animals and people impacted by the grant, which may be shared on American Humane’s and on authorized third parties’ print and/or digital media for any lawful purpose, including for any fundraising appeals, direct mailings, promotions, publications, press releases, social media posts or other public communications, and in all media, whether nor or hereafter known, throughout the world in perpetuity, without payment or other consideration. I affirm that any photos, videos or other media that I will provide to American Humane contains only my own original material or material for which I have full authority to grant the use rights, and do not infringe on the rights of any third party.

I understand that all such materials will become the property of American Humane and will not be returned, and I release and forever discharge American Humane from any and all claims, demands, rights, promises, damages, and liabilities arising out of or in connection with the use or distribution of said photographs, video, and/or biographical information, including any and all claims for invasion of privacy, appropriation of likeness, or defamation.

I hereby affirm that I have read and fully understand the contents of this agreement and that I am legally competent to and freely enter into this waiver, release, and consent to use the images, biographical information, and narrative content as stated above.
Disclosure and Agreement Signature (Place cursor in box, hold left mouse button while moving cursor to sign):*

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Second Chance® Fund Grant Application

Basic Agency/Organization Info

Animal's Information

Incident Information

Required Documentation