Friends Don't Let Friends Have Litters

Spay / Neuter Program

Program funded by Friends of the Shelter, Inc.

Owner Information

* indicates a required field

Pet Owner Name *

Owner Address *

City *

Zip Code * (please use a standard 5 digit or zip + 4 format)

County *

Phone *

Email *

Pet Information

Pet Name *

Species *

Cat Dog Other

Breed *

Color *

Age *

Weight *

Sex: *

Male Female

Pregnant *

Yes No

Income Information

Friends of the Shelter offers assistance to pet owners in the Northern Kentucky area who may be unable to pay for spay/neuter services for their companion animals. This program does not have current income restrictions although we would ask that those who can afford to pay their veterinarians/clinics full cost for surgery will do so and allow us to use these limited funds for those who would otherwise be able to access this important service. We do need to collect information about family income for those who access this program in order to apply for grants which partially fund this service.

Please indicate your family income by selecting the appropriate category *

less than $30,000 between $30,000 and $50,000 between $50,000 and $70,000 over $70,000 my family qualifies for welfare, food stamps, assisted housing or other similar financial assistance programs administered by governmental or private nonprofit charitable organizations

Pet Owner Affidavit: By submitting this form, I certify that the selected phrase describes my personal household financial circumstances, to the best of my knowledge.

Voucher Information

Please indicate your request by checking any of the following that apply:

I am requesting a voucher to assist with the cost at a prefered veterinary clinic I have no preference for veterinarian/clinic

Enter Veterinarian or clinic name)

If you can afford to pay for spay/ neuter services, please enter the amount here