Petstablished | Manage your Animal Welfare Organization (AWO) with our easy-to-use software.

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Personal Information

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

* GenderMaleFemale

Country

*State/Province

Date of Birth

* Month

* Day

* Year

Qualification Information

Proof of income can be any one of the following combinations. Please be sure to remove or conceal sensitive personal information like your social security number. We do require that the name and address on supporting documents match that of the applicant. 1.) Medicaid Card (adult, not child) and copy of last tax filing. 2.) WIC Card (current date) and copy of last tax filing. 3) Letter granting Social Security Income (adult, not child) and copy of last tax filing.

What proof of income are you providing?

IRS 1040Medicaid CardBank statementsOther

Upload proof of income

House hold Income

$15, 000 or below$15,001 to $25,000$25,000 to $50,000

Pet Information

Pet's Age

Pet's Species

DogCat

Pet Name

Pet's Gender

MaleFemale

What color is your pet?

Examples: black and white, brindle, gray tabby, calico, etc.

How much does your pet weigh?

Owned animal certification

Our SNIF program was designed to provide spay/neuter support for OWNED animals of households making $50,000 or less per year. This program is NOT for feral cats or stray cats/dogs. If you need assistance with feral cats and/or stray cats & dogs, please contact Operation Catnip or contact spay/neuter clinics like Safe Care or Five County Spay/Neuter.

I certify this is animal is not a feral or stray. It is my personally owned animal and I will provide proof of ownership.

Proof of pet ownership
(upload proof of ownership below)

Examples of proof of ownership: past vet bill with your name and the pet's name, past/current rabies certificate with your name and the pet's name, or a picture of the pet in your home or with you/your family. **Pictures of cats or dogs in the woods or an open field will not suffice. We need to see them WITH their family.

Is your pet up to date on rabies vaccine?

YesNo

I would like my voucher:

Mailed to me at Address ProvidedEmailed to me at Email Address Provided (you must be able to print out the voucher and present at time of procedure)

Disclaimer

By typing my name in the box below, I certify that I personally own the animal(s) listed and I understand that copay is due on the morning of appointment. If any other services are requested by myself or the veterinarian that I will pay for those services on the morning of appointment or at time of pick up. As a reminder, the voucher only pays for the spay/neuter surgery, the associated pain medication, and a rabies shot. Any other services offered and/or requested, such as but not limited to bloodwork, vaccinations other than rabies (FeLv, Distemper, Bordatella, etc.), allergy or anxiety medications, heartworm testing, or heartworm and flea/tick preventives, are your responsibility to pay. They will not be covered by PFLNC. I agree that by typing my name in the box below, I agree that it is binding just as if I signed my signature.

Type your name in the box provided.

We are able to provide this program to the community due to generous donors and grant foundations. These donors and foundations require annual reporting and like to see pictures of the animals being helped. No people names are used in the reports, just the pets. Can we use your pets picture to be shared in our reports?