Fuzzmugs Pet Food Request Form

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Email*

Age

Name of person who referred:*

Address*

Address Line 1

Address Line 2

CityState

Zip Code

Our pet food assistance program is meant to be a temporary solution to help supplement pet caregivers out during unexpected financial hardship.

Fuzzmugs typically only provides food enough for 2 dogs and 2 cats.

Limit one recipient per household.

Fuzzmugs doesn't allow recipients to sell, trade, or try to return any merchandise that was received from Fuzzmugs to any store.

Fuzzmugs reserves the right to deny or terminate anyone for any reason from our program.

Fuzzmugs nor the pet food/supply manufacture doesn't guarantee the freshness or quality of the pet food or supplies and is not liable for any problems that could result from using the pet supplies or feeding your pets the food giving to you by Fuzzmugs.

Are you a senior citizen or veteran?

Your Income.

Name of employer if applicable:

Briefly tell us about your current financial situation and why you need help.

Are you currently receiving pet food from any other organization?

Tell us about your animals!

What kind of pets do you have in your home?*

DogsCatsOthers (more info below)

How many dogs do you have at your home and what are their (approximate) sizes?

What type of dog food do you usually use? (Specify brand, wet/dry, etc.)

How many cats do you have in your home?

What type of cat food do you usually use? (Specify brand, wet/dry, etc.)

Do any of your pets have dietary restrictions?

Are your dogs and/or cats spayed/neutered?

YesNoBoth intact & spayed/neutered pets.

Do you have appointments for pets that are not spayed/neutered?

YesNo

If you have appointments, what is the scheduled date?

What type of other animals do you have in your home? We can't guarantee we can provide other types of animal food, but we'll try!

Do you feed any outside community cat colonies? Usually, we can help provide food for you. With the intention that you will be able to focus more on spay/neuter.

How many community cats do you feed?

Do you TNR? This is when you trap feral cats to be spayed/neutered and then released back to where you trapped them.

Do you have any question for us?

Is there any other pet supplies that you my need?

Currently we make arrangements to delivering your pet supplies to you.

By submiting my application to recieve pet food and/or pet supplies assistance, I agree to follow the rules and all of the information that I have provided is accurate.

Fuzzmugs Pet Food Assistance Request Form

FuzzMugs was created to help animals.

We are a small volunteer based 501(c)3 nonprofit animal welfare group.

Our mission is to help pets and their caregivers that are experiencing financial hardship. We want to ensure that no pet goes hungry and help reduce local shelter intakes.

If you need assistance with dog or cat food for your family, please fill out this form and submit pictures of your pets. Someone will contact you as soon as we can.

We may ask for Drivers License or State ID to verify who you are.