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ResQ Pet Pantry Questionnaire

This form registers you for participation in the ResQ Pet Pantry program. If approved, you will be contacted with information on how we are able to assist you and your pet(s). In emergencies, please contact us at resqpantry@gmail.com.
Please know we are run by volunteers, funding is by donations only , the pet pantry may be paused if we have no funds available to assist, we apologize for any delays in reply to your requests. We do not intake any animals.

To The ResQ does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations.

For which pets in your household are you requesting pet food assistance?
Provide the following information about each pet: name, type (cat/dog/bird), pet's age, approximate weight.

Example: 1) Boots, cat, 2 yrs, 8 lbs 2) Fido, dog, 5 yrs, 35 lbs

Do your pets live indoors, outdoors, or indoors/outdoors?

Skip to next question for cat colonies.

Indoor onlyOutdoor onlyIndoor/Outdoor

Cat colonies : If assistance is being sought for outdoor cat colonies, please explain details of colony below.

For example, indicate the colony's location, number of cats, what you are currently feeding, etc.

Are all of your pets spayed or neutered?

Yes, all of my pets have been spayed/neutered.No, my pets are not spayed/neutered.Some of my pets are spayed/neutered.

If your pets are not spayed/neutered, do you intend to get them spayed/neutered?

Yes, but I cannot afford it now and need help to get my pets spayed/neutered.No. I do not plan to have them spayed/neutered at this time.All my pets are already spayed/neutered.Yes, I plan to get them spayed and neutered when I am able.

Please provide the name and phone number of the veterinarian or veterinary practice that you most recently have used.

If you do not have a veterinarian, please write "N/A" in the space below.

Please explain what types and brands of foods you currently feed your animals.
Please note that we may not be able to provide you the same brands that you are currently using.

Be as specific as possible, for example, Purina One Urinary Tract dry cat food or Pedigree Choice Cuts in Gravy wet dog food.

Are there any non-food items that you need help with, for instance, flea and tick preventatives, litter, etc.?
Please note that we may not be able to provide you the same brands that you are currently using and we may not be able to supply all requested items.
We are funded by donations and what we may send may not be the same items you currently use or requested.

Please list items below.

Please list in general terms all of the food and other items for which you are requesting our assistance?
This does not guarantee all items will be provided. We operate by donations only and have a limited budget per request.

For example: cat food (dry- we do not provide wet food), litter (scoopable), flea treatment (dog), etc.

Applicant's Information

Please share as much as possible with us about your current financial situation so that we can make an informed decision on your eligibility.

Do you currently receive any Human Social Services Assistance?
Social Security /Disability assistance?
Unemployment payments from WV?
Check all that apply & you MUST UPLOAD pictures or documents of all Verifications of Assistance you mark Yes to.

SNAPDisability/SSIMedicaidUnemploymentWICI am currently not receiving any assistance, but am still suffering financial hardship.Other (explain at the end of the application)

Please Upload any documents showing financial need: such as unemployment status, disability, social security, SNAP approvals, etc.
This is required for approval if applicable.

IMPORTANT!! Do not skip this step! Please provide a screen shot of a document that shows your participation in any of these programs. Your application will not be processed if you have checked that you receive benefits, but have not provided proof.

Please briefly explain your current situation and why you are requesting assistance through the ResQ Pet Pantry.

Please include information like your current job status (unemployed, employed, retired, student, part-time, disability etc.) or recent change(s) to your income which have led you to need assistance at this time. What income do you have to support your pets? How were you paying for your pets before today, when you are seeking our assistance?

What is your current living situation?

Please explain whether you own or rent your home, are living with family, living in a hotel, are homeless, etc. (This will help us determine whether we will be able to deliver items using internet or store services or have to physically deliver items to your place of residence).

How long do you anticipate needing the Pet ResQ Pantry assistance?
We do have a limited time we can offer assistance to you, usually up to 3 months once a year.
You may apply again for reconsideration if your circumstances have not changed.
All assistance is based on our funding availability.

1-3 monthsOther (explain at the end of the application)

ResQ Pet Pantry Registration and Request Form

Personal Information

ResQ Pet Pantry Questionnaire

Applicant's Information