Application Request for Assistance
Tucker’s Gift is a 501(c)3 non-profit organization dedicated to providing basic needs, including access to veterinarian services and food as needed, to the pets of individuals struggling with HIV/AIDs.

Many individuals faced with HIV/AIDs find themselves lonely and seeking companionship, finding solace in their beloved pets. It is a depressing fact that in today’s society many still stigmatize and isolate individuals that have the HIV/AIDs virus. With the cost of personal medical care and medication needed on a monthly basis, many are left with the difficult decision to face surrendering their companions or going without basic necessities in order to meet the needs of their pets.

To support these individuals, we as an organization team up with local non-profits in North Texas to ensure the pets of those most in need receive our services. As a small organization, we are not in a position to determine the financial need of applicants for our services, and so we require a referral from a non-profit that specializes in working with individuals with HIV/AIDs.

Tucker’s Gift wants to thank you for your consideration and support. To help us in the effort to determine who most requires our assistance, we request that the accompanied application be filled out and submitted along with a letter of referral and recommendation that has determined economic hardship and need. Please know that the information provided will only be shared with Tucker’s Gift board members and remain confidential, except when required by law.

Your assistance is greatly appreciated. Thank you for working with us to ensure the pets of those struggling with HIV/AIDs continue to receive the love and support they require.

The Tucker’s Gift Board of Directors
910 20th ST
Plano, TX 75074

Email address *
Date *
First and Last Name *
Your answer
Address: *
Your answer
Contact Email Address and Phone Number *
Your answer
Pets: Name *
Your answer
Type/Breed *
Your answer
Age of Pet: *
Your answer
Weight of Pet: *
Your answer
Does the application have a referral from a 501(c)3 Organization *
Type of Services Needed: *
Please be explicit as to what veterinary care is needed: *
Your answer
*A maximum of two pets per client may receive assistance from Tucker’s Gift.
**Veterinary services to be provided by Tucker’s Gift approved partners. Services are limited to a maximum $100 credit per pet per client at the Veterinarian directed to by Tucker’s Gift . Pet Grooming is not a covered service.
Name of Referring Organization: *
Your answer
Name of Case Worker submitting this application: *
Your answer
Phone number & Email address of Case Worker: *
Your answer
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy