First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Text/Pager Email

Information about your pet

Add your pet's name, or if you are applying to spay/neuter free-roaming cat(s) without a name, please type "Feral" or "Stray" following by an incrementing number. For example, the first application would be Feral 1, the second application would be Feral 2, etc.

Is your pet a cat or dog?
Choose one: Cat Dog Other

Please describe your pet's breed. If you are trapping stray cats, please type "Unknown," unless all cats in the area are the same breed. *

Is your pet male or female? If you are trapping cats, choose "Unknown"*
Choose one: Male Female Unknown

Please estimate your pet's weight, in pounds. Please note that most clinics have minimum and maximum weight requirements. If your pet is very small/young or large, please confirm the requirements with the individual clinics. *

What is the approximate age of your pet? Please note that most clinics have minimum and maximum age requirements. Please confirm the requirements with the individual clinics.*

Is this a stray or feral (community) cat?*
Choose one: Yes No Unsure

Where did you get your pet, and how long have you owned him/her?*

Spay and neuter are considered major surgery and your pet will be under anesthesia. Please describe any medical conditions that may impact the outcome of this procedure. For example, is your pet in heat, pregnant, nursing, heartworm positive, or unhealthy in any way? If your pet is healthy, please indicate that as well. *

Information about your household

Please indicate your annual household income:*
Choose one: Less than $20,000 $20,000 to $40,000 $40,000 to $60,000 $60,000 to $80,000 $80,000 to $100,000 $100,000 to $150,000 $150,000 to $200,000 More than $200,000

How many adults are in your household?*

How many children are in your household?*

How many animals are in your household?*

Pet owners must contribute a minimum of $20 per pet, unless an exception has already been approved per KGARL's website. What amount of money are you able to contribute to your pet's surgery?*
Choose one: $0 - I have approval from KGARL $20 $30 $50 $75 $100

I hereby certify that the animals which will be sterilized are either owned by the applicant, or strays with no known owners. All information provided above is truthful and correct to the best of my knowledge. Additionally, I understand that the King George Animal Rescue League will not be held liable for any additional charges unrelated to the sterilization procedure. I accept that I am responsible for all additional fees charged by the veterinarian. I acknowledge that vouchers will not be replaced, reissued, or extended beyond the original date of expiration without KGARL's approval. Furthermore, I understand and agree that any veterinary service, including the sterilization procedure, is taken with all the standard risks associated with a surgical or veterinary treatment. I agree that the King George Animal Rescue League will not be held liable for any complications due to surgery or treatment, including, but not limited to, death, injury or illness.*
Choose one: I agree with the above statements I do NOT agree with the above statements