Pet Food Pantry Application

"*" indicates required fields

Comments

This field is for validation purposes and should be left unchanged.

Name*

First Last

Email*

example@example.com

Phone Number

Please enter a valid phone number.

Address*

Street Address Address Line 2 City State / Province Postal / Zip Code

Number of people living in household.*

Best Time For Us to Contact You*

Annual Household Income*

Please explain why you need to rely on TPBP pet food pantry*

I understand that only residents of Lucas county are eligible for this program and I must provide proof of residency.*

Yes

I understand that the pets in my household must be spayed/neutered to qualify for the pet food panty.*

Yes

I understand that if my pet is already spayed/neutered I must provide proof on or prior to my first visit.*

Yes

I understand that food will be provided once a month.*

Yes

I understand that the amount of food provided will be at TPBP's discretion.*

Yes

I understand that food is donated through various sources and TPBP cannot guarantee the freshness, quality, or safe consumption of the food.*

Yes

I understand that there is a $1 fee per visit to help with costs.*

Yes

I understand that TPBP has the right to revoke or deny participation in this program at any time.*

Yes

Please list all dogs/cats in house.*

Proof of Income (Medicare, Medicaid, Snap, Verification of Income Level, ETC)

Max. file size: 1 GB.