Benny's Pet Foundation Grant Dispersal

Benny's Pet Foundation Grant Dispersal

Our grant process is a 2-step process: 1 - Approval & 2 - Disbursement. This form is for organizations that have been approved for a grant by Benny's Pet Foundation.
Organization Name
Organization EIN
Email Address of Person completing form (in case of questions)
example@example.com
Veterinarian Practice name that check should be made payable to & mailing address where check should be sent.
Veterinarian Practice *
Is there an Account # or Invoice # that we should reference:
Veterinarian Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Vet Phone Number

Area Code Phone Number
Animal's Name that Needs Non-Routine Care: *
Please provide details regarding this animal & the need (background, illness/injury, how he/she came to rescue): *
DOCUMENTS - Below are the documents that need to be attached to your application. All fields have 1024kb maximum, acceptable file types - pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif

Note: Bill/estimate must be current and not for services rendered more than 7 days prior to contacting BPF.
Actual Bill or Estimate from Vet *
Do you have a photo of the animal in need?
Additional photos can be sent to us at Benny@BennysPetFoundation.Org
Is there any additional information you would like to provide?
Should be Empty: