Onslow County Partners for Animal Welfare Application for Spay/Neuter Certificate

You can send in the $39.00 for the certificate application on the donate page, just specify that it is for the spay/neuter certificate, or pay cash at Pet Mart on Rt 210 in Sneads Ferry or pay by credit card or pay pal on our home page.Call if you have any other questions at 910.745.7930 Once your application has been reviewed and approved you will be notified to pick up the certificate at PetMart on RT 210 in Sneads Ferry or you can request that it be sent to you.

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ONSLOW COUNTY PARTNERS FOR ANIMAL WELFARE APPLICATION FOR SPAY/NEUTER CERTIFICATE

These certificates are intended for fosters and low income families who otherwise could not afford the procedure. One certificate per family per year and not intended for feral cats. They are valued at$80.00. Please fill out this form and send to or P.O. Box 745, Sneads Ferry NC 28460. You can also pick up or drop off completed application at PetMart.Payment is cash only at this location. If approved you will be notified to pick up your Spay/neuter certificate at PetMart located at 1056 NC HWY 210 in Snead’s ferry by appointment only. Phone number 910 327 2342You will need photo ID and proof of residence of Onslow County.

Name:______

Address:______

Phonenumber:______

Email:______

Employer:______

Name of animal:______Breed:______Sex:______Color:______

Age:______Veterinarian:______

Is your pet pregnant?______Is your pet nursing a litter?______

Certificates are issued with an expiration date of90days. Please schedule your appointment before the expiration date. Once a certificate expires you must re-apply. Your pet must be up to date on Rabies and all vaccinations. If they are not current the veterinarian will administer them for an additional charge not covered by this voucher.

IMPORTANT PLEASE READ AND INITIAL

_____Ihereby agree to release, indemnify and hold harmless Onslow County Partners for Animal Welfare, Inc. from any and all claims, actions, demands, rights, judgments or expenses arising from or by reason of any and all known or unknown damages, claims or actions which may arise during the surgical sterilization of my pet

._____Furthermore Onslow County Partners for Animal Welfare, Inc. will not be held liable for any additional charges related to the spay/neuter procedure. I understand that many veterinarians require specific vaccinations prior to sterilization and I will be responsible for compliance with these requirements.

_____ Complications during or following the surgery, due to undiagnosed conditions is the responsibility of the pet owner

._____ the veterinarian has discretion on whether or not he/she will sterilize the animal. If the animal is too sick or has other medical problems, the veterinarian can decline to perform the surgery.

_____ There may be additional charges for non-routine surgery, which would include a pregnant or in estrus cycle (heat), infections, undescended testicles, false pregnancy, obesity or females that have had previous litters.

Signature:______Date:______

Certificate #______