Spay/Neuter Project Application - Humane Society Tacoma

Application Guidelines
• Use a separate application for each pet surgery.
You may request additional applications by calling
(253) 383-2733, ext. 5838.
• The pet owner is responsible for all costs over those
allowed by the Humane Society. This project provides
funds for spay or neuter surgery. Please discuss any
further costs or procedures with your veterinarian
prior to surgery.
• The Humane Society Spay/Neuter Project is only
available to residents of Pierce County age 18 and
older.
• If you have any questions about this application or
the Humane Society Spay/Neuter Project, please call
the Humane Society at (253) 284-5857.
• Limit three surgeries per household.
Contact Us
Membership.................(253) 284-5823
Volunteering .......................(253) 284-5832
Humane Education ...................(253) 284-5814
Events/Dog-A-Thon ....................(253) 284-5869
Public Relations ..........................(253) 284-5844
Spay/Neuter Clinic ......................(253) 284-5857
Behavior Help Line ....................(253) 284-5840
Found Dogs..........................(253) 596-8561
Found Cats/Other ..........(253) 596-8989
General Info.........(253) 383-2733
The Humane Society Spay/Neuter Project is made
possible through generous donations from the
community and local veterinarians who allow this fund
to provide surgeries at little or no cost to low-income
Pierce County residents.
Thank you to our compassionate community
veterinarians, and the generous Humane Society
members and donors who have made this program
possible.
Humane Society Hours
For business hours, please call us
at (253) 383-2733 or go to
Please mail application to:
www.thehumanesociety.org, and
find our hours on the home page.
Spay/Neuter Project
The Humane Society for
Tacoma & Pierce County
2608 Center Street
Tacoma, WA 98409-7694
The Humane Society
for Tacoma & Pierce County
Saving lives. Sharing lives.
P: (253) 383-2733 / F: (253) 572-3678
2608 Center Street / Tacoma, WA 98409
www.thehumanesociety.org
Spay/Neuter
Project Application
STEP 1
•
•
•
•
Pet Owner Agreement
Additional charges from the veterinarian may be added. Please discuss this
with the veterinarian in advance.
I waive any and all claims against the
Humane Society for Tacoma & Pierce
County which may result from my pet’s
surgery.
I have read and understand the guidelines section on the back of this form.
All my answers are correct to the best
of my knowledge.
STEP 2
Information About You
P L E A S E
P R I N T
N E A T L Y
___________________________________
Name
P R I N T
Pet’s Name
Street Address (include Apt. #)
Pet’s Age
___________________________________
□ Dog
□ Cat
□ Male
□ Female
City
--
State
Zip
-------------------------------------
N E A T L Y
___________________________________
__________
________________
______________
Breed
Color
Mailing Address (if different from street address)
How did you learn about the Spay/Neuter Project?
___________________________________
City
_________________
DATE
P L E A S E
___________________________________
___________________________________
__________________________________
SIGNATURE
STEP 3 Information About Your Pet
(
State
Zip
___________________________________
)
Home Phone (with area code)
Best time to reach you:___________________
NOTE: THIS APPLICATION WILL BE
RETURNED TO YOU IF INCOMPLETE
OR UNSIGNED.
***L I M I T 3 P E T S P E R H O U S E H O L D***
Date of Birth: Month_____ Day_____Year______
I certify that I am a resident of Pierce
County, that my gross monthly household
income is $______________, and that
________ people are supported by this
income.
__________________________________
Signature
STEP 4
Mail Completed Application
Please mail application along with a
self-addressed, stamped envelope to:
Spay/Neuter Project
The Humane Society for
Tacoma & Pierce County
2608 Center Street
Tacoma, WA 98409