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Income-Based *Dog Spay / Neuter Program Application

  1. All fields must be filled out accurately in order to be processed.
  2. How did you get your dog(s)
    (Check all that apply)
  3. On the day of surgery your dog will receive (at no charge) a spay or neuter surgery. You may elect to purchase the following:
    (Check all that apply) * To participate in this program, dogs must be 12 weeks to 10 years of age; in good health; working breed or mixed breed; under 60 lbs.
  4. Initial
  5. Initial
  6. Initial
  7. Initial
  8. Signature of Owner or Agent:
  9. *Please be sure to check your spam/junk folder if you do not receive a response to your application within 2-3 business days.*

  10. Leave This Blank:

  11. This field is not part of the form submission.