Spay | Neuter Application

Use this form to apply for discounted Spay|Neuter services through the Windham County Humane Society.

Information about You
Name *
Name
Home Phone
Home Phone
Cell Phone
Cell Phone
Work Phone
Work Phone
Your Address *
Your Address
Information on pet(s) to be spayed/neutered
Tell us about each of your pets. If you have more than three pets, please email us details about the additional pets that do not fit on this form.
Pet One
Pet Type *
Gender of the pet *
Please indicate what vaccines this animal needs. *
Pet Two (Optional)
Pet Type
Gender of pet
Please indicate what vaccines this animal needs.
Pet Three (Optional)
Pet Type
Gender of pet
Please indicate what vaccines this animal needs.
Terms
With my acknowledgement, I certify that the information I have given is true. I understand if I am scheduled for a clinic and fail to appear without notice, I forfeit my eligibility for the program. I affirm that I am a resident of Windham County, Vermont.
I agree to the program's terms as enumerated above.
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