Purr Love Pet Food Pantry Enrollment Form

Purr Love Pet Food Pantry Enrollment Form

Please fill out the following information to determine your eligibility for our pet food pantry. Once we receive and review your application, we will be in touch. Thank you.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Number of pets in your household, colony or those you feed outdoors
Types of pets you have
What is your relationship to these pets?
Are your pet spayed or neutered?
I have provided proof of spay/neuter for each pet I'm enrolling.

If No, please explain below in the Additional Comments section below. I understand Delco Loves Animals can help me find low cost or no cost spay/neuter for my cat(s) or a discount for my dog(s). Once I have an appointment scheduled I will email the proof of the appointment to DelcoLovesAnimals@gmail.com. I understand this will not disqualify me from participating in the pet food pantry and that I will provide proof of spay/neuter within 3 months of being accepted.
What is your primary reason for seeking assistance?
I understand that if my pets are not spayed/neutered, I must provide proof of spay/neuter for each of my enrolled pets with 3 months of enrollment.
I understand that I must provide proof of my Delaware County, PA residency.
I understand that I may receive food for each of my pets only once per calendar month and that it is my responsibility to pick up food at one of the Pet Food Pantry's designated dates and times. I will not receive food outside of set dates and times. For the most current locations, dates, times and inclement related updates I should check the Delco Loves Animals Facebook page or call: 484-388-9259.
I understand that the pet food I receive is meant to be supplementary and will not cover an entire month's worth of food or be specific to my pet's dietary needs.
I understand that I and the authorized adult, identified above, are the only people to whom Delco Loves Animals will provide food for my enrolled pet(s), listed above.
I understand that I will be given a Delco Loves Animals Pet Food Pantry identification card that I must present each time I pick up food for my enrolled pet(s) listed above.
I understand that I Delco Loves Animals reserves the rights to refuse service to me.
I understand that I Delco Loves Animals reserves the right to revise, change and/or assign additional conditions to enrollment in the Delco Loves Animals Pet Food Pantry without notice.
How did you hear about our Pet Food Pantry?
Additional Comments or Questions
Signature
Should be Empty: