Friends of the Animal Shelter
701 Lower Lake Road
St. Joseph, Mo. 64504
Non-profit 501(c3) Organization
________________________________________________________________________
SPAY DAY USA 2010 APPLICATION (FEBRUARY 23RD)
All animals must be current on vaccinations prior to spay/neuter surgeries. This program is offered only to families of low income. Proof of income must accompany application. This can include a copy of your most recent W-2 or tax return info.
Name_________________________ Address__________________________
City__________________________ State,Zip__________________________
Home Phone___________________ Cell phone_________________________
Place of employment___________________________________________________
Spouse or partner name and place of employment___________________________
Number of people living in household_______________
Employment______________________
Regular Veterinarian___________________________________________________
Animal Information
Pet Name Dog / Cat Breed Age Sex Weight
1.______________________________________________________________________
2.______________________________________________________________________
3.______________________________________________________________________
4.______________________________________________________________________
Friends of the Animal Shelter would like to thank you for applying for our Spay Day USA Program. We are limited in the number of surgeries we arrange by the amount of donations we receive. You will be notified by phone to set up your appointment.
Please return your application to:
St. Joseph Animal Control and Rescue Shelter
Attn: Friends of the Animal Shelter/Spay Day USA
701 Lower Lake Road
St. Joseph, Mo. 64504
Forms must be received no later than February 19th, 2010