* ALL FIELDS REQUIRED
If a question does not apply to you, fill in the blank with "NA"
* 1. Name: (First and Last) * 2. Rescue or Sanctuary Name: * 3. If you are a 501(c) 3 please give EIN#: * 4. Address: * 5. Address 2: * 6. City: * 7. State: * 8. Zip Code: * 9. Home Phone: (xxx-xxx-xxxx) * 10. Cell Phone: (xxx-xxx-xxxx) * 11. E-mail: * 12. Number of pigs being rescued * 13. Why they are being rescued? (Such as: abandon; neglected; abused;) Short explanation * 14. Who will be responsible for the rescued pigs? * 15. Who will be helping with the rescued pigs? * 16. Name of Veterinarian: * 17. Vet's phone number: * 18. Vet's full Address including State and Zip: * 19. Approximate cost of rescue including fencing, shelter, transportation and vetting: * 20. How will these pigs be cared for after they have been spayed/neutered * 21. Approximate cost of spaying and neutering, including any criporchids or pregnancies:( Rough estimate) * 22. What other funding is available to you? * 23. Are homes available for these pigs and if not are you prepared to keep them and care for them for their life time? Explain * 24. Will the person you rescue these pigs from be permitted to have any more pigs? (Yes=Y No=N ): * 25. Will any of the pigs be staying with the previous owner(s)? (Yes=Y No=N ):
* 16. Name of Veterinarian: * 17. Vet's phone number: * 18. Vet's full Address including State and Zip: * 19. Approximate cost of rescue including fencing, shelter, transportation and vetting: * 20. How will these pigs be cared for after they have been spayed/neutered * 21. Approximate cost of spaying and neutering, including any criporchids or pregnancies:( Rough estimate) * 22. What other funding is available to you?
* 23. Are homes available for these pigs and if not are you prepared to keep them and care for them for their life time? Explain * 24. Will the person you rescue these pigs from be permitted to have any more pigs? (Yes=Y No=N ): * 25. Will any of the pigs be staying with the previous owner(s)? (Yes=Y No=N ):
* I understand that the Folley Rescue Fund is for spay ing and neuter ing only , and that payment will be made directly to my veterinarian. I also understand this is just part of the cost and have made arrangement s for the balance. I understand that I am just making application and this is no guarantee that I will receive any funding. I agree not to hold TPPA responsible for any and all liability nor any of their staff or board of directors. I agree to send all receipts plus a few picture s within six months of receiving this funding. I further agree that these pigs are not my own and will be put up for adoption whenever possible.
Due to a constant demand for funds from the Folley Rescue Fund and the large numbers of pigs needing rescue, the applicant understands that this is a one-time grant. If additional funds are needed in the future (even for pigs within the same rescue), another separate application for the additional funds must be submitted. This is only to help offset the cost . In no way do we guarantee funds to complete the rescue or pay the entire bill.
This is only to help off set the cost and in no way do we guarantee funds to complete the rescue or pay the entire bill.
* Signature Date
