Food Assistance

STEPS IN THIS PROCESS

1. Review the qualifications to ensure your eligibility for our Low-Income Food Assistance Program.
2. Submit an application
3. Submit your proof of income in the online form or mail it to:
   HAVA
   PO BOX 243
   Raymond, WA 98577
4. You will be notified when you have been approved and can pick up food at the HAVA Food Bank.
5. Beginning January 1, 2026, all approved recipients are required to volunteer at least 2 hours per week at the shelter to remain eligible.
   Register as a volunteer here: https://hava-heart.org/volunteer/
   Sign up for volunteer shifts here: https://hava.ivolunteer.com/

WHY WE ARE ADDING A VOLUNTEER REQUIREMENT

HAVA’s pet food assistance program helps keep pets with their families, which strengthens our entire community. The need for support has grown, and our small volunteer team is stretched thin. Asking participants to contribute a couple of hours each week helps keep the program sustainable, supports the animals in our care, and ensures we can continue offering help to families who truly need it.

QUALIFICATIONS

HAVA’s Pet Food Assistance program offers temporary support to help individuals and families feed their pets. It should not be considered a long term or permanent source of pet food.

To qualify, your household must meet the income limits listed below. Proof of income is required and can be submitted online or mailed to HAVA at PO BOX 243, Raymond, WA 98577. If you are unsure whether you qualify, call us at (360) 942 4716 and we will help you figure it out.

ACCEPTABLE PROOF OF INCOME OR ASSISTANCE:

Applicants must submit documentation that clearly shows their full name and full residential address. Documents that do not include a complete address cannot be accepted.

Acceptable documentation includes:

• Wage statement or paycheck stub
• SSI or SSDI statement
• Approval letter for cash assistance
• Approval letter for DSHS medical coupons
• Unemployment benefits statement
• L & I statement
• Approval letter for food assistance or SNAP

If your document does not show your full address, your application will be delayed until updated documentation is provided.

DISCLAIMER

HAVA does not donate to anyone breeding, selling, or flipping animals. We reserve the right to refuse anyone under any circumstance.

APPLICATION FOR LOW-INCOME FOOD ASSISTANCE

Please enable JavaScript in your browser to complete this form.

1About you

2About your pet

3Low-income Acknowledgement

Your Name

First Name *

Last Name *

Are you over 18? *

• Yes
• No

Email *

Phone *

Do you live in North Pacific County?Select OneYesNo

Mailing Address *

Address Line 1

City

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

Zip Code

Different Physical Address

• My Mailing address and physical address are the same.

Physical Address *

Address Line 1

City

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

Zip Code

Next

How many cats do you own? *

How many dogs do you own? *

Are these animals your pets? *

• Yes
• No

Are you feeding feral animals? *

• Yes
• No

Tell us more about your animals. Names, gender, ages, breeds, weight/size, etc. *

Which animals are fixed (spayed/neutered)? *

• All of them
• None of them
• Some of them

Vet Authorization

• I authorize my vet to speak with a HAVA representative

Select your current veterinary *--Select One--Willapa Veterinary Services (Raymond or Grayland)Vetters Animal HospitalCountry Pet Veterinary ClinicOther

Please provide your veterinary name and contact information: *

Anything else you think we should know that wasn't covered above?

Next

Number of people living in your household: *

Number of adults with income in your household: *

Total Annual Household Income: *

You may be required to submit evidence of low income to qualify for this program. Below are acceptable documents.

• Wage Statement/Paycheck Stub
• SSI/SSDI Statement
• Approval Letter for Cash Aid
• Approval Letter for DSHS Medical Coupons
• Unemployment Statement
• L & I Statement
• Approval Letter for Food Stamps

Please upload your evidence:

Drag & Drop Files, Choose Files to Upload

Acceptable document types: pdf, jpg, png
Note: If you are unable to upload, you can email it to [email protected] or mail it to PO BOX 243, Raymond, WA 98577

IMPORTANT NOTICE!

Submitting false or misleading information on this form will result in your request being denied. If we determine that the information provided is intentionally inaccurate or that you are applying on behalf of someone else, you may be permanently disqualified from receiving any future assistance from HAVA. All sources of income must be disclosed, including government or private assistance. We take fraud seriously and will not tolerate abuse of this program.

I also agree not to hold HAVA, its volunteers, and benefactors legally liable if your pet(s) become ill or the food upsets a pets(s) stomach.

Sign & Submit