ResQ Fund Application for Spay/Neuter & Wellness

Please check the boxes that best represent the reason for your application:

Please let us know in the space below the total number of pets in your household. Please include ALL the pets in your household. For example, 2 dogs, 4 cats, 2 birds, 1 turtle etc. If you are asking for help with feral cats that do not belong to you, please indicate that and skip all personal questions.

Provide the name(s) for EACH pet for which you are applying for assistance. Include Type/Name/Sex. If you are asking for help with feral cats that do not belong to you, please indicate that and skip all personal questions.

For what type of medical services do you require assistance? Please check all that apply.

If you are applying for a dog to be spayed or neutered, approximately how much does your dog weigh?

Are all of your pets up to date on rabies vaccinations? Please be prepared to present proof of rabies vaccines.

All pets must be living in a healthy environment and good living conditions. Please check the answer that best represents your pet's living environment.

To be approved to receive ResQ Funds, we require ALL pets in your household to be spayed/neutered, unless there is a compelling reason why they cannot be. Please check the answer below that best applies to your situation.

Are all of your pets for companionship and not used for breeding or illegal activities? Please explain if any of your pets are used for breeding or sport/entertainment purposes.

Please use the space below to clarify questions above or to share any additional information that you would like for the ResQ Fund team to know when considering your application. If you have any questions, please also include them here.

If you do not receive help with your pet(s), what will you do?

Will you need help with transporting your pets to and from vet for care?

Are you applying for spay/neuter assistance through the WV Spay and Neuter Program (WVSNP)?

Have you applied for/requested/picked up any coupons or discounts through organizations like Animal Welfare Society of Jefferson County or Spay Today?

When your situation improves would you consider contributing back to the ResQ Fund to help others?

If you are receiving assistance through any other programs through TTR or another charity, please check all that apply.

If you are applying for help with feral cats, do you require assistance with trapping them?

If you are requesting financial assistance, please explain your current situation and why you are requesting assistance through the ResQ Fund. Please include information regarding 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.
Applicants must demonstrate a financial need to qualify for assistance.

Please check answer which best describes your current employment status:

Do you currently receive any Human Social Service Assistance? Check all that apply:

If you are receiving any of the benefits referenced above, please upload one document showing proof of financial need, such as unemployment status, disability, social security, SNAP benefits, etc.

Which range below best reflects your monthly income from all sources in your household?

Please enter the total number of persons in your household for whom you are responsible, including yourself.

Is there anything you would like to share with us about your pet or why you need our help that you feel would be beneficial for our decision team to know when deciding your application?

We aren’t always able to award 100% of the costs of services needed. For some awards, we may only approve a partial award. Are you willing or able to contribute a small percentage towards these services? If so, how much can you afford at the moment?

May we text you?

Do you object to having your name checked through the local court system?

If you have a veterinarian, do you give us permission to contact them for a reference, if one is needed. If yes, please enter the name and telephone number of the veterinary practice that you are currently using.

If you do not have a veterinarian, please indicate below.

Please indicate your agreement to the following: I understand that the ResQ Fund may not cover all veterinary charges for my pet's care. If donations from the ResQ Fund are insufficient to cover the entirety of my pet's charges, I understand that these charges are my financial responsibility, and not that of The ResQ Fund or To The ResQ.

I give my consent to the volunteers and veterinary staff to transport, hospitalize, anesthetize and perform spay/neuter, and other medical services such as but not limited to vaccinations, ear mite/flea treatment, etc., on my cat/dog. I understand there are risks associated with any medical or surgical treatment. I accept this risk and understand that I may be responsible for the costs of treating any complications. I also understand that due to the nature of the spay/neuter clinics, there is no pre-anesthetic blood testing performed prior to surgery, and as such, there may be risks to my pet, including but not limited to serious allergic reactions, seizures, and even death. I hereby release To The ResQ, The ResQ Fund and all representatives associated with the care of my pet herein from any and all liability related to any services obtained in connection to this request for funding. Signing (or typing if applying digitally) my full name below serves as my signature and my agreement to the ResQ Fund requirements and releases made above.

By signing below, I certify that the above information is true, and I understand that providing false information may result in nullifying this application. I understand that this application does not constitute that any services will be rendered. I understand The ResQ Fund has the right to deny any application. Signing (or typing if applying digitally) my full name below serves as my signature and my certification of truthfulness of the statements I have made above.

Please enter today's date below.