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
OPTION 2
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), veterinarians, directors, officers, employees or volunteers liable for any complications arising from the vaccinations, spay or neuter or medical procedures.
