Kat Snips Voucher Application

Please call your Requested Veterinarian BEFORE submitting this application. You will need the scheduled appointment date and payment must have gone through prior to a voucher being created.

1. Not all of the veterinarians spay or neuter kittens under 6 months of age.
2. Fee is $55 per cat, payable to Kat Snips
3. Your voucher is effective for 90 days from the date of issuance.

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– Step 1 of 2

I am at least 18 years of age, have read the Kat Snips' Program Requirements, Authorization and Release, fully understand it and agree to the program requirements: *

• Yes

Number of Cats to be Spayed/Neutered *

Price: $55.00

12345678910

Cat's Owners Name (First and Last) *

First

Last

Person Paying for the Voucher (if different than the owner)

First

Last

Phone

Email *

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Cat's Information

Click on the "+Add" button below to add more than one cat. Each cat MUST have an entry

Cat's Name

Male or Female *— Select Choice —MaleFemaleUnknown/Not Sure

AgeOver 6 monthsUnder 6 months

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Veterinarian Information

Requested Veterinarian *— Select Choice —Brookside Veterinary Hospital – Ann ArborSalem Veterinary Services – SalemTecumseh Veterinarian Hospital – TecumsehLenawee County Humane Society – AdrianLakelands Trail Veterinary Clinic – Stockbridge

Appointment Date *

Total *

Order Summary

Item	Quantity Qty	Total
There are no products selected.
Number of Cats to be Spayed/Neutered	1	$55.00
Please consider adding a donation of $10 or more	1	$0.00
Total		$55.00

$0.00

Payment Method *— Select Choice —Credit CardMail in Check

Please consider adding a donation of $10 or more

Minimum Price: $10.00

Acknowledgement and Release *

• Kat Snips will not spay/neuter cats being sold for profit. Violators will be denied future service, and financial responsibility for provided spay/neutering service will be yours. I release and discharge Kat Snips, its board members, officers, volunteers, and insurers from all claims of any kind that I might have against any of them because of damages, losses, or injuries to any person or animal and/or property resulting from my use of the service of Kat Snips or any of its referral veterinarians or clinics.

Payment Information *

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If you selected “Mail in Check” for the Payment Method, please print this form and mail to:
525 E Michigan Box #144
Saline, MI 48176

Click Authorization and

If you selected “Mail in Check” for the Payment Method, please print this form and mail to:
525 E Michigan Box #144
Saline, MI 48176

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