Holly F. Reynolds Community Assistance Program

Please accurately complete the application in its entirety. If you qualify for our Holly F. Reynolds Community Assistance Program, you will be asked to schedule an appointment at the CAAWS approved veterinary clinic. A CAAWS volunteer will send the voucher to the veterinary clinic. The voucher will cover the cost of a spay or neuter surger, rabies and routine vaccinations only. All other services, medications, and/or products are the responsibility of the owner. CAAWS is issuing a very limited number of vouchers, and they are issued on a first come first basis to approved households. Applicants must be residents of one of the following parishes: East Baton Rouge, West Baton Rouge, Livingston, Iberville, East Feliciana, West Feliciana.

Please note you will be responsible for purchasing a rabies license if required by law. If your animal is already up to date, you will need to provide the veterinary clinic with proof of rabies.

There is a limit of one pet per household. CAAWS at sole discretion may make exceptions.

The income limit is no more than 200% of the federal poverty level, for each household. (See link below) Each household must submit a copy of the previous year federal tax return, AND two paycheck stubs dated within the last two months, and/or SNAP or Social Security benefits.

https://www.healthcare.gov/glossary/federal-poverty-level-fpl/
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail *
Parish*

Are you employed?*
How many people are in your household?*
Only include yourself, your spouse, and dependents as defined by the IRS
What is your total household yearly income?*
Do you or a member of your household receive any of the following:*
How much are you willing to pay towards the cost of the visit?*
Are you willing to provide CAAWS with proof of income and household size?*

YesNo

Please Upload Your Two Most Recent Pay Check Stubs*

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Please upload a copy of your most recent SNAP determination letter*

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Please upload a copy of your most recent social security determination letter*

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Please upload a copy of your 2023 1040, 1040A, or 1040EZ as certification of household size*

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I certify that the information contained in this application is true to the best of my knowledge. I understand that any false statements will result in immediate denial of my application, or restitution being sought by CAAWS for a surgery that is already performed. I agree to provide the Capital Area Animal Welfare Society with proof of income and to follow the guidelines outlined in the follow up emails received from CAAWS. I agree to indemnify and hold harmless the Capital Area Animal Welfare Society from any direct or consequential damages arising prior to, during, and after the veterinary visit. This includes any and all manner of actions and causes of action, suits, debts, dues, accounts, bonds, covenants, agreements, judgments, claims, and demands whatsoever arising from or relating to the visit.
Click to Do you agree to the terms and conditions outlined above?*

YesNo
By writing your name you are certifying that you will follow the terms and conditions and any instructions given by CAAWS. This constitutes your electronic signature.*
Made Possible by the Generosity of the Banfield Charitable Trust
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