Name * First Name Last Name Breeding- * We do not provide services to breeders or those who intend to produce a litter. We believe if you are going to produce puppies you should plan for them and have the appropriate resources to provide for them. I am not a breeder, and do not plan to produce puppies Is this an emergency? * Yes- If this is an emergency complete the application and then text 970-520-7176 Not an emergency Phone Number * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Make sure you check your spam. Our reply will come from peacefulcoexistencedogs@gmail.com and may end up in your spam folder. Subject Assistance Application Select from the options below- Please note we help with 1 dog per household to give you a hand up, we can not provide for all of the dogs you own. You can re-apply after 6 months to help with another dog. Were here to help, but do expect owners to take some accountability as well. Dog Food (Once per Quarter) Rabies Shot Dapp 4 in 1 vaccine Micro Chip Spay (limited funding, waitlist utilized as needed) Neuter (limited funding, waitlist utilized as needed) Other- Explain below What is the situation causing your request for support? * Explain your need Can you afford to contribute part of the cost of services you are requesting? * Enter the amount you can contribute below (if any) What is your plan for being able to support your dogs needs in the future: * Our program provides a temporary hand up what is your plan to support your dogs need long term. Consent to Communication * Peaceful Coexistence does not share your information outside of our organization, but you must check this box to consent to receive communication from Peaceful Coexistence Ltd. With out your consent we cannot reach out to you regarding your application or update you about programs and opportunities. I consent to communication No-Call No-Shows * If you are approved for services and you no-call no-show on your appointment day you will be removed indefinitely and be unable to receive services. I understand Email Communication * You must check your spam/ junk email box our emails tend to go there. I will check my junk/spam email folder Thank you!
