Pet Food Bank Application - Individual

Denkai Animal Sanctuary offers temporary assistance to help individuals and families in need feed their pets and should not be viewed as a permanent source of pet food. Denkai does not donate to anyone breeding, selling or flipping animals and reserves the right to refuse anyone under any circumstance, such as someone who is a breeder. Below are the general guidelines. However, every request will be reviewed on a case-by-case basis. Denkai will provide food for up to five pets per household. Requirements and Eligibility to Receive Pet Food Donations 1. Proof of unemployment, income status, or disability with a valid driver license or some form of ID 2. Recipients must be 18 years of age or older. ID may be required 3. Pets are for companionship and not for breeding or illegal activities 4. All pets must be spayed/neutered. Denkai can help with assistance for spaying or neutering 5. Pets must be a part of the family with inside shelter and must be maintained in a healthy environment and living conditions 6. Pet food recipients cannot take on any additional animals while receiving assistance 7. Understand that all pet food and supplies are donated and may not be the current brand you use to feed your pet, which may upset your pet’s stomach 8. Agree not to hold Denkai Animal Sanctuary, its volunteers, and benefactors legally liable in the unfortunate event your pet(s) become ill or the food upsets a pets(s) stomach 9. Recipients agree not to resell, redistribute or attempt to return to a store, any food or care items received from Denkai. 10. Denkai will make every effort to consider special requests for certain formulas or flavors of dog and cat food (i.e., Senior, indoor, etc.), but are only able to give what is available at the time 11. Provide us with a photo of your pet (you may include yourself in the photo). Accepted file formats include: gif, jpg, pdf or png. Email to care@starelief.org. Should you violate any of the above requirements Denkai Animal Sanctuary will terminate assistance immediately without notice. • Our Pet Food Pantries are located in Cortez, CO and Wellington, CO

Please list all pets in your home. Pet Name Type of Pet (Dog, Cat, Horse, Other) Pet Age Pet Weight If Dog or cat, is your pet spayed or neutered? Special needs?

Examples include: Medicaid Disability Food Stamps

Can you provide proof of low income?

Please provide the name of your current or past veterinarian and their phone number. If you do not have a veterinarian, please state that and the reason you do not have a veterinarian for your pet(s)

Please let us know why you are in need and what your current job status is.

Please upload a current photo of your pets.

By electronically signing below, you agree to the provisions about and attest the information provided is truthful. The undersigned hereby release Denkai Animal Sanctuary and all representatives associated therein, from any and all liability related to the pet food and/or care items provided.

Denkai Animal Sanctuary does not retain any sensitive or confidential information. Denkai Animal Sanctuary assures confidentially of all records received.