Shelter Friends, Inc.

Request for Assistance Form

Please provide as much information as possible which will allow us to better determine how Shelter Friends, Inc. might be able to help. If we cannot provide assistance, this information may be forwarded to another organization or other resource we network with, who may be able to better respond to your request.

Date*

Month

Day

Year

First Name*

Last Name*

Driver's License Number and State Where it was Issued*

Cell Phone*

Alternate Phone*

Email*

Physical Address*

City / State / Zip Code*

Name of Alternate Contact*

Phone*

Do you give your alternate contact permission to make decisions related to this animal(s) or bird(s)?*

Yes

Is the animal(s) or bird(s) you are requesting help for located somewhere different from the address you provided above?*

Yes

If you answered Yes to the previous question, please provide as much specific information on the location of the animal(s) or bird(s). If there is no address for the location, give the nearest crossroads and any landmarks that can be easily located.

In what county is the animal(s) or bird(s) you are seeking help for located?*

What kind of animal(s) or bird(s) are you requesting help for?*

Is the animal(s) or bird(s) you are requesting help for:*

An Animal(s) or Bird(s) You Found

Owned by Someone Else You Can Identify

Your Own Animal(s) or Bird(s)

What type of assistance do you need?*

Fostering an Animal(s) or Bird(s)

Rescuing an Animal(s) or Bird(s)

Sheltering an Animal(s) or Bird(s)

Veterinary Bill Assistance for an Injured or Sick Animal(s) or Bird(s)

Veterinary Care for a Sick or Injured Animal(s) or Bird(s) You Found

Other

If you answered Other to the previous question, please explain the kind of help you need.

Every Animal Deserves a Chance.

Your support helps provide emergency care and hope for animals who need it most.

Shelter Friends, Inc.

P.O. Box 171

St. Charles, MO 63302

Shelter Friends, Inc. is a
501(c)(3) non-profit organization.

Tax ID # 46-2114407

All donations are tax deductible.

STAY CONNECTED

314.750.7979

info@ShelterFriendsInc.org

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