Mutternity Leave Grant

Thank you for participating in our Mutternity Leave Program! To ensure that no pet parent is turned away due to finances, we have created the Mutternity Leave Grant. Please answer the following questions (your answers are kept confidential). A staff member will respond within 5 business days to let you know the status of your application.

Mutternity Leave Grant

Name*
First Last
Best Contact Email*
Phone*
Address (if you are unhoused, please put cross streets)*
Zip Code*
Annual Income*
Family Members (including yourself)*
Name of Dog(s)*
Please list any other unaltered dogs in your household by sex

Example: 1 male, 2 females
I understand that Almost There Rescue (ATR) is a nonprofit organization and that the Mutternity Leave and the Mutternity Leave Grant Programs are facilitated by ATR. My answers will be kept confidential and a staff member will respond within 5 business days to let me know the status of my application.*
- I understand
I affirm and certify that all the information and answers to questions herein are complete, true and correct to the best of my knowledge and belief.*
- Yes