• Pet NameDog or CatMale or FemaleAltered or IntactRabies vaccination current (Yes or No)Date DueApproximate Weight 
    Please type your answers in the corresponding boxes and press the plus button on the right to add additional pets
  • *Please note that to continue using the HSCC Pet Food Pantry program for longer than 3 months, all household pets must be fixed and current on their rabies vaccination within that 3-month period. HSCC will provide assistance with spay/neuter and vaccines on request. Assistance will be provided on case-by-case basis. HSCC reserves the right to remove clients from the Pet Food Pantry Program at their discretion.
  • I agree that the above information is correct at the time of application. I understand that I can change any of the information as needed. I understand that to continue using the HSCC Pet Food Pantry program for longer than 3 months from time of application, ALL my pets must be fixed (or appointment for surgery has been scheduled), and current on their rabies vaccinations.