Pantry Application

Name *

First

Last

Date / Time *

Date

Time

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

# of dogs in the home *

Are dogs spayed/neutered? *

Explain why you are requesting help from the Pet Food Pantry? *

All TPBP Pet Food Pantry clients acknowledge, understand and consent to the following terms on this program. *

I understand that only residents of Lucas county are eligible for this program and must provide proof of residency. ice
I understand that pets in my household must be spayed/neutered to qualify for the pet food pantry.
I understand that food will be provided up to two pets.
I understand that the amount of food provided will be on TPBP’s discretion.
I understand that the food is donated through various sources and cannot guarantee the quality, freshness or safe consumption of the food.
I understand that there is a $1 fee per visit to help with costs.
I understand that TPBP has the right to revoke or deny pet parents from this program at any time.