Tripawds Gear Fund Application
Three Legged Dog Support Harness Donation Program
NOTE: Application deadline is the 1st and 15th of each month. You may apply a maximum of two times.
First Time Applying?
Yes, This is my first application.
I have applied once before.
Original Application Date:
Applicant (Full Name)
NOTE: Name must match supporting documentation submitted
Shipping: Delivery Address
Shipping: City, State & Zip Code
Tripawds community participation is encouraged to get and share the best amputation recovery and care tips. Register at
Ruffwear Webmaster Harness Sizing
Take the girth measurement carefully while your dog is standing up. Please measure carefully, there are no returns or exchanges.
See sizing chart above. Please measure carefully. There are no returns or exchanges.
NOTE: Color may be substituted based on availability.
NOTE: Annual household income disclosure required in addition to Need Qualification documentation.
Total annual income of all people in household.
Number of People in Household
Entitlement Program Enrollment Proof
1. Attach proof of enrollment in state or federal entitlement program, including: WIC, welfare, food stamps, Medicaid, VA Disability Compensation, Social Security Disability or Supplemental Security Income.
2. Attach proof of current annual household income at or below 200% of federal or state poverty guidelines. See Table 1 below for details. Proof of income can be provided in the form of: a) current pay stub(s) indicating at least six months of income, or b) your most recent income tax forms. All documentation must show the same name(s) as indicated on the vet clinic receipt for amputation surgery.
NOTE: We do not need your social security number. Please omit from all documents.
I AGREE to provide a photo of my dog wearing the harness along and brief article for publication by Tripawds if selected as a grant recipient.
INCLUDE: Copy of photo ID
INCLUDE: Financial Need Documentation...
1. Proof of entitlement program enrollment (award letter or payment stub), OR:
2. Proof of income (Paycheck stubs indicating at least 6 months of income or most recent Tax forms)
EMAIL ALL SUPPORTING DOCUMENTATION TO
Qualifying Household Income
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