Clinic Equipment Grant Pre-Grant Qualification Questionnaire (Start Up)

12% of survey complete.

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