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You Can Make a Difference - Help Support SPAY/USA Millions of healthy, adoptable cats and dogs are euthanized each year in the U.S. because there simply are not enough homes for them all… Help support SPAY/USA, a program of North Shore Animal League America.

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Registration Form

PRIVACY POLICY: Information given to SPAY/USA is confidential, and will not be shared with any
individuals or organizations. We will not sell or rent the information you provide online to third parties.

Please complete and submit this form to be referred to a low-cost clinic in your area.

First Name: 
Last Name: 
Address: 
City: 
State:  Zip Code: 

Area Code: 

Daytime Phone: 


County: (e.g. Jefferson County)


E-Mail Address: (case sensitive)


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DOGS # of animals to be spayed/neutered

Approx. Age(s) If known

Approx. Weight
Male Dog(s)

under 6 mo. 1 yr. - 5 yrs.
6 mo. - 1 yr. over 5 yrs.

up to 20 lbs.

21 - 50 lbs.

over 50 lbs.

Female Dog(s)

under 6 mo. 1 yr. - 5 yrs.
6 mo. - 1 yr. over 5 yrs.

CATS # of animals to be spayed/neutered Click below if  gender unknown Pet Tame Stray Feral/ Wild 

Approx. Age(s) If known

Approx. Weight
Male Cat(s)

Unknown
under 6 mo. 1 yr. - 5 yrs.
6 mo. - 1 yr. over 5 yrs.
over 2 lbs.

over 2 lbs.

Female Cat(s)

Unknown
under 6 mo. 1 yr. - 5 yrs.
6 mo. - 1 yr. under 5 yrs.

under 2 lbs.

over 2 lbs.

Do you receive any of the following forms of public assistance?
Unemployment Social Security Income Other
Medicaid Disability  

How did you hear about us?
(Check all that apply)

Surfing the web Referred by vet or program Telephone Book
Pet Store Humane Group Radio PSA
Flyer Fund Raising Mailing Television PSA
SPAY DAY USA North Shore Animal League America Unknown
Heloise Newspaper Article Other
Friend/Relative Used SPAY/USA Before

If you have any additional questions when you get our reply, call us at 1-800-248-7729.
Due to the heavy volume of inquiries submitted, follow-up emails will not be answered.