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Pet Food Bank Enrollment

This form is for NEW members only. Please complete the form and a staff member will contact you within 72 hours with next steps.

Step 1 of 3

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Full Name*
First Name Last Name
Email*
Phone*
Home Address*
Street Address Address Line 2 City State ZIP Code
Why are asking for assistance at this time?*
- Senior
- Recently laid-off or reduced hours due to covid-19
- Fixed income
- Other
Are you on any form of public assistance? If yes, please check all that apply.*
- SNAP/EBT
- WIC
- SSI/SSDI
- Medi-cal
- GR
- Unemployment
- None at this time

How many pets do you have?*
- 1
- 2
- 3
- 4
- More than 4
What type of pets do have? (i.e., I have 1 dog, 2 dogs, 1 dog and 2 cats, etc.)*
If you are asking for cat food, is it for stray and/or community cats?*
- Yes
- No
- Not applicable, I don't have cats
- I don't know what a stray community cat is
How much does each pet weigh? (ie., One dog weighs 10 pounds, one dog weighs 40 pounds, and both cats weigh 5 pounds)*
Have all pets been spayed or neutered?*
- Yes, all have been spayed/neutered
- No, none are spayed/neutered
- Some are spayed/neutered, some are not
Have the pets been vaccinated in the last 12 months?*
- Yes, all have been vaccinated in the last 12 months
- No, none have been vaccinated in the last 12 months
- Some have been vaccinated in the last 12 months, some have not been vaccinated
Does each pet have a microchip?*
- Yes, all
- No, none
- Some have a microchip, some do not have a microchip

Please read the following policies and waivers and electronically sign your name to acknowledge Pasadena Humane's policies and requirements for continued enrollment in program.
I agree to spay/neuter my pet (s), keep each pet up to date on vaccines, and microchipped.*
I agree
I agree not to take responsibility for any other pets while I am receiving food bank services. Accordingly, I acknowledge I will not be able to add any additional pets to my profile for food bank.*
I agree
I understand that if I do not comply with the requirements and provide proof of vaccines, spay/neuter and microchipping within an agreed upon time frame, Pasadena Humane may terminate my enrollment in the program.*
I agree
By electronically signing my name below, I affirm that the information provided above is true to the best of my knowledge and will adhere to program policies and requirements.*
If you are in emergency need of pet food, such as your pets going multiple days without eating, please contact the Outreach Programs Coordinator at (626) 792-7151 ext 283 or email helpingpaws@pasadenahumane.org
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Questions? Contact us at hello@pasadenahumane.org

Animal Resource Center

Admissions – Lost & Found – Pet Support Services

9:30 a.m. to 5:30 p.m. 7 Days a week

Appointment recommended. Please call 626.792.7151 ext. 975 to make an appointment.

Shelter Shop

Monday to Saturday: 10 a.m. to 6 p.m.
Sunday: 11 a.m. to 6 p.m.

*Shelter Shop is open for walk-in customers.

Visiting Hours

Saturdays and Sundays: 2:00 to 5:00 p.m. (unless otherwise noted).

Adoptions

By Appointment: Daily, 10:30 a.m. to 1:30 p.m.

Walk-In: Daily, 2:00 to 5:00 p.m.

Contact

Address:
361 S. Raymond Ave.
Pasadena, CA 91105

Phone:
626.792.7151

Fax:
626.792.3810

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