• Pet Food Bank Application

  • Do you participate in any of the following community programs? If so, please do not complete this form and instead contact your organization directly to inquire about help with pet food.*

  • Person Information (Pet Owner/Guardian)

  • *Please check your email for our reply. We generally reply in 2 to 24 hours to make an appointment with you to pick up the food. Please check your email.

  •  -
  • Primary Phone Number Type*

  • 0/150

  • Pet Information

  • Dogs Spayed or Neutered*
  • Can you provide Spayed or Neutered documentation?*
  • Are Cats Spayed or Neutered?*
  • Can you provide Spayed or Neutered documentation?*

  • Certification

  • I hereby certify that to the best of my knowledge and belief the above information is true and correct.

    I give my permission for a representative from the Palm Springs Animal Shelter Pet Food Bank to contact me if more information is needed or to set up a pick up day/time.

  • Signed this Day*
     - -
    2 digit month, 2 digit day, 4 digit year
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  • Should be Empty: