APAW Spay/Neuter Assistance – Amelia County residents only!!
P.O. Box 725
Amelia, VA 23002
www.apawinc.org
apawinc@gmail.com
Request for Spay/Neuter Assistance
INCLUDE A SELF- ADDRESSED STAMPED ENVELOPE
Or email to apawinc@gmail.com
Allow 4-6 weeks for delivery.
This request form will not be accepted at your Veterinarian’s clinic.
Name:___________________________________________________________
Address:___________________________________________________________________________
Phone # :___________________ Email address:______________________________
You are requesting spay/neuter assistance for the following:
Enter number below: (Maximum of 3 pets/family)
Male Dog(s) ________ Female Dog(s)_______
Male Cat(s) ________ Female Cat(s)_______
Description of Animal(s):__________________________________________
AMELIA COUNTY RESIDENTS ONLY: Attach Proof of Income for additional assistance:
An acceptance letter from Social Services for government benefits, a bank statement showing Social Security benefits, a tax return for self-employed individuals, or 5 consecutive pay stubs.
Participating Veterinarians:
Dr. Kaski, Countryside Veterinary Center 804-561-5450; Amelia Bovine Clinic 804-265-5958;
Dr. Carr, Blackstone Animal Clinic 434-292-1298; South Central Spay/Neuter Clinic 434-207-2612