SNAP Application

Dear S.N.A.P. applicant

Thank you for applying for the Spay/Neuter Assistance Program. We are happy to see that you know the importance of sterilizing your pet. The NHHS, a private, non profit organization, is trying to help curb cat overpopulation by making sterilization surgery more affordable and available. We help those individuals whose animal has perhaps had a few litters or is not yet s/n and cannot afford or do not qualify for any other program available (i.e. Plan A or B)

We need the following information:

• You must fill out the application in full. Missing information will delay the approval process.
• List all the vaccinations your pet has had and provide a copy of the vaccination certificate or receipt from the veterinarian.
• Your pet must be current on both the rabies and distemper vaccinations. If your pet does not have current vaccines, you must purchase them at the clinic for $10.00 each.

If you are unable to provide any of this information, please include a note indicating your situation. We try to accommodate as many applications as possible, but unfortunately we have limited resources and must limit participation to a certain degree.

We review applications as soon as possible after receiving them. Once you have been approved and you’ve sent the supporting materials, you will be contacted and given an appointment and pre-surgery instructions for an upcoming clinic. You must bring current vaccination records with you on the day of the surgery.

Downloadable Application

Download our SNAP application and submit it by mail or fax.

Address: PO Box 572, Laconia, NH 03246
Fax: (603) 524-9539

Online Application

Name:		Email:
Day Phone:		Night Phone:
Address:		City:
State:		Zip Code:
How were you made aware of S.N.A.P?
Pet's Name:
	Dog Cat	Color:
	Male Female	Age:
Breed:		Weight:

Is your pet pregnant or nursing?	Yes No
Does your pet need a microchip?	Yes No
What vaccinations are needed?	Rabies Distemper
Date of Previous Vaccinations:	Rabies Distemper Never vaccinated
Heartworm Test Date (for dogs):
Veterinary Clinic Name:
Notes/Comments/Questions:

I understand that this document will be retained by NHHS and is completely confidential.

By submiting this form, I further attest that the information given is true and understand that giving false or incomplete information may result in my application being denied.