Spay/Neuter Assistance Application | New Hope Animal Rescue WV

We will not accept any more applications after 6/30/2020. We are processing the applications submitted and they will all be sent out by the end of this week. We have received several requests for TNR and will respond to those requests.

Thank you for your interest in helping to reduce the number of unwanted litters.

Attention! All information must be provided with your application or it will not be processed!

If you prefer to print and mail your application, please click on the View PDF Form below.

View PDF Form

Personal Information

Your Name

Address

City, State and Zip Code

County

Phone #

How should we send your authorization(s)?

Employment Information

Place of Employment

Monthly Income

Spouse's Place of Employment

Spouse's Monthly Income

Are any other household members employed?YesNo

Total Gross Monthly Income (includes alimony, child support, public assistance, retirement, SSI, etc)

How many people are supported by this income?

Pet Information

1. Pet's Name

Type of Pet

Sex

Breed

Age

Color/Markings

Where did you get the pet?

2. Pet's Name

Type of Pet

Sex

Breed

Age

Color/Markings

Where did you get the pet?

3. Pet's Name

Type of Pet

Sex

Breed

Age

Color/Markings

Where did you get the pet?

Do you have more than 3 pets needing spayed or neutered? yes

If yes, list additional information here:

Please select one of our participating veterinarians.

Do you have any additional questions or remarks?

Instructions

If this application is approved, you will receive one authorization form for each pet being spayed or neutered. Once you receive the authorization form(s), call the vet to make an appointment. You must present the authorization form(s) to the vet when you take your pet for its appointment.

If you are unable to keep your appointment, you must give at least 24 hours' notice to the vet's office.

You Must Read and Acknowledge The Statement Below

By typing my name in the line below, I understand all questions on this application must be answered or this application will not be processed. I also certify the accuracy of the information I have provided.

Type your name (in lieu of signature)

Today's Date

Thank you for helping to make your pet a healthier and happier companion, and for helping stop pet over-population. Please call our office at 304.562.0300 if you have any questions.