Clinic Equipment Grant Pre-Grant Qualification Questionnaire (Expansion)

8% of survey complete.

Question Title

Click here if you just want to see the questions in this pre-application. If you fill out questions in this pre-application it will be submitted to PetSmart Charities. This link will allow you to see the questions in advance without your information being submitted.

Click <a href="http://www.petsmartcharities.org/assets/documents/expansionclinicquestions.pdf" rel="nofollow" target="_blank">here</a> if you just want to see the questions in this pre-application. If you fill out questions in this pre-application it will be submitted to PetSmart Charities. This link will allow you to see the questions in advance without your information being submitted.

Thank you for your interest in applying for a grant from PetSmart Charities. The following information will help us determine if our clinic equipment grant application is the right fit for your program. It should take approximately 5 minutes or less. Once we get your responses back we will talk with you further about what we believe the best options are for you. If this is a good fit we will then send you the application electronically. If it does not appear to be a fit at this time we will refer you to a resource page that may be helpful. Before completing this questionnaire, please carefully review the requirements for applying for a grant with PetSmart Charities on the PetSmart Charities website: Grant Guidelines.

Question Title

* 1. Contact Information

Contact Name: *

Name of Organization: *

Address: *

Address 2:

City/Town: *

State: *

What radius will your clinic serve (i.e. 60 miles) *

Contact Email Address: *

Contact Phone Number:

Question Title

* 2. Which of the following best describes your organization?

501(c)(3)

Government/Municipal agency

A Tribal Entity

A University

Other