Just fill out the application below. If you have any questions, email us and let us know.
Casper's Fund Application
Date:
How did you hear about Casper's Fund?:
Name:
Street Address:
City/State/Zip: County:
Contact Phone:
Email address:
Which Option would you like to use?:
OPTION 1 (Dog only, small co-pay)
OPTION 2 (Dogs and cats, volunteer requirement, no co-pay)
Why would you need assistance to pay for your pet's spay/neuter surgery?
Too many bills Unemployed/laid off Medical bills Vet tests/vaccines I can't afford Other
If you chose 'Other', please explain:
If you are choosing OPTION 1, how much of a co-pay can you afford?:
If you are choosing OPTION 2, do you have a special interest in a particular activity for your volunteer hours? :
If you are choosing OPTION 2, do you have a special skill you could use for your volunteer hours?:
INFORMATION ABOUT PET:
Male Dog Female Dog
Male Cat Female Cat
Age of Pet:
Weight of Pet:
Breed/Color/Description:
Has this animal ever been to a vet?:
Yes No
If yes, which vet?:
Has this animal ever given birth?:
Would you like to use your own vet or one of our partner clinics for your pet's surgery?:
Partner clinic My own vet
If you'd like to use your own vet, please give us the name, address and phone number of your vet:
Does your pet need any of the following services?:
DOGS: Rabies Vaccinations
Heartworm test Deworming
CAT: Rabies Vaccinations
FIV/FeLV test Deworming
I hereby certify that the foregoing information is true and correct and that I have not omitted anything which would make my application false or misleading. I will not hold Casper's Fund (AARF), No More Homeless Pets Atlanta Clinic, their parent organizations, veterinarians, directors, officers, employees or volunteers liable for any complications arising from the vaccinations, spay or neuter or medical procedures.
