application for services

Name *
Phone *
Address *
Employment Address *
Employment Address
Do you already have a shelter animal selected? *
If yes, is your animal a dog or a cat?
If yes, what is the shelter's address?
If yes, what is the shelter's address?
If yes, what is the shelter's phone?
If yes, what is the shelter's phone?
If you are selected, would you be comfortable sharing your story (not the trauma aspect) on our website to spread the word about our services? *
Survivor Pledge *
I certify that I am a Survivor of sexual assault and/or domestic violence. I certify that either I or my parent/guardian is at least 18 years of age. I pledge to make a reasonable commitment of time and effort, and to affect scheduling and lifestyle changes in order to make this relationship with my pet work. I pledge to provide appropriate and timely veterinary care for the life of my pet. I pledge provide my pet with the proper nutrition for optimum health, and to keep my pet the proper weight, neither obese nor emaciated. I pledge to give my pet ample aerobic exercise daily, and make sure that at least three times a week they get to run and play and get tired out. I pledge to provide my pet with mental stimulation in the form of either play, interactive toys, training, or off territory leash walks, DAILY. I pledge to provide my pet with enough training and/or behavioral management so as to enable him to be a welcome part of my community, or managed safely. I pledge that if, for any reason, I can no longer keep this pet, I will not abandon them, and I will return to the shelter (if required) or leave ample time to find a new, appropriate home, tell the new owners truthfully all the pet’s behaviors, good and bad, and follow up occasionally to make sure the pet is safe and content.