Pet Pantry Animal Survey 2021

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* 1. First and Last Name (as it appears on your ID)

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* 2. Address

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address

Phone Number *

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* 3. Please enter your date of birth

Date of Birth

Date

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* 4. Michigan Humane is pleased to offer temporary support and assistance to Michigan pet owners in need. Here are some important considerations to keep in mind as you join our program!

Our operations are based on the generous donations of others, therefore we cannot guarantee that food and veterinary care for your pets at all times. When available, we provide free dry/wet cat and dog food, kitty litter and animal care supplies.

Applicants must be at least 18 years old.

It is our goal to see all of the animals (under the age of 8) in our program sterilized (fixed). This service is provided at no charge to you.

Once approved, you're eligible to return to the Pet Pantry every two weeks. You do not need to wait for your exact day. For example, if you come on a Thursday, you could return on a Tuesday, approximately two weeks later.

Please inform a staff member if you have any changes to your name, phone number, address, alternate contacts, etc. so we can keep your records up to date.

Please let us know if you add or remove animals from your household.

Only one owner can be registered per animal (but alternate pick-ups can be added).

Breeding or planning to breed your pet will result in immediate removal from the program.

Items received from the Pet Pantry may not be offered for sale, sold or traded. Doing so will result in immediate removal from the program.

Participation in the Pet Pantry may be revoked for disruptive behavior including inappropriate language, violence or threat of violence, or hostile behavior towards Michigan Humane staff, volunteers, fellow clients and/or affiliates.

Registration and participation in the Pet Pantry program may be revoked at the discretion of Michigan Humane staff for any reason.

At staff's discretion, employees may visit your home to provide resources or to ensure your participation is in compliance with our program guidelines.

By typing your name, you agree to the above mentioned guidelines. Please type your name.

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* 5. List anyone who you would like to give permission to pick up food or supplies for you if you are not able to make it into the Pet Pantry yourself. If you do not wish to give anyone else permission to pick up your food, please write: "none," "N/A" or "not applicable."

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* 6. What is your primary mode of transportation?

My Car

Ride Share

Bus

Bike

Walk

Unknown

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* 7. Are you interested in breeding or having puppies in the future?

Yes

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* 8. Do you currently breed or mate any of your pets?

Yes

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* 9. Tell us about your pet

Dog or cat?

Name of pet

For dogs - If unknown, please do not enter "mixed" or "mutt." Please include your best guess of a breed.

For cats - If unknown, enter DSH for short haired cats or DLH for long haired cats)

Please enter your pet's breed.

Color

Weight

Age

Gender

Is your pet already spayed or neutered?

Is your pet up to date on vaccines?

Does your pet sleep indoors or outdoors overnight?

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* 10. Do you have another pet to enter?

Yes