Helping Paw Fund Application
Before completing the application, please review the guidelines at http://carecentercu.org/wp-content/uploads/2016/10/CARE-Center-Helping-Paw-Fund-Application.pdf. At this time, we can only provide support to individuals and families living in East Central Illinois. NOTE: APPROVAL IS REQUIRED BEFORE SERVICES ARE PROVIDED.
First Name
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Last Name
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Street Address
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City
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State
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Zip Code
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Phone Number
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Alternate Phone Number
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E-mail Address
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Number of Adults in Household
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Number of Children in Household
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Number of Cats in Household
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Number of Dogs in Household
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Number of Cats/Dogs in Household that are Spayed/Neutered
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Number of Cats/Dogs in Household that are Vaccinated
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How did you hear about the CARE Center's Helping Paw Fund?
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