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.

QUALIFICATIONS

HAVA’s Pet Food Assistance offers temporary assistance to help individuals and families feed their pets and should not be viewed as a permanent source of pet food. To be eligible, you must meet the household income requirements listed below. You will need to submit your proof of income via the online application or by mail to HAVA. Our mailing address is PO BOX 243, Raymond, WA 98577. If you are unsure if you qualify, please call us at (360) 942-4716, and we will let you know.

ACCEPTABLE LOW-INCOME DOCUMENTATION:

• 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

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

Last

Are you over 18? *

• Yes
• No

Email *

Phone *

Mailing Address *

Address Line 1

City

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Zip Code

Different Physical Address

• My Mailing address and physical address are the same.

Physical Address *

Address Line 1

City

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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

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

By submitting this application, you certify all the information provided on this application is accurate. 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