Vernon & Diana Harris Peaceful Passage Application

Thanks to the generosity of Vernon and Diana Harris, ARF is able to provide limited financial assistance of up to $150 per pet to qualifying Jackson County residents who need help covering euthanasia and/or cremation services for their dog. Payment will be made directly to the veterinary practice. Funding is limited, and assistance is not guaranteed.

This application is valid for one dog only. Households seeking assistance for multiple dogs must submit a separate application for each dog. Each application will be reviewed independently, and approval of one application does not guarantee approval of another.

Eligibility Requirements

To be considered for assistance, applicants must:

• Be a resident of Jackson County, North Carolina.

• Upload proof of residency (such as a driver's license, utility bill, lease agreement, or other official document showing a Jackson County address).

• Complete this application in full.

Applications will be reviewed by ARF and may include consultation with the applicant's veterinarian when appropriate. Approval decisions are made solely at ARF's discretion and are based on program guidelines, available funding, and the information provided by the applicant and veterinary professionals.

Applicant Information

Proof of Jackson County Residency

Dog Information

Veterinary Information

Assistance Requested

ARF may provide up to $150 in financial assistance toward euthanasia services and communal cremation (no return of cremains). Funding is limited and assistance is not guaranteed. If approved, payment will be made directly to the veterinarian practice.

Explanation of Need

Timeline of Need

Financial Need

Preferred Veterinary Practice

Please note: Listing a preferred veterinary practice does not guarantee that services will be provided through that practice. ARF will coordinate with the applicant and veterinary provider to determine available options.

Applicant Certification

• I certify that all information provided in this application is complete, true, and accurate to the best of my knowledge. I understand that any false, misleading, or omitted information may result in denial of assistance or revocation of any assistance awarded.

• I authorize ARF (Humane Society of Jackson County) to verify information provided in this application, including residency and veterinary information, and to request additional documentation as necessary to evaluate my eligibility.

• I understand that submission of this application does not guarantee financial assistance and that all funding decisions are made at ARF's sole discretion, subject to available funds and program requirements.

• I understand that any payment will be made directly to the veterinarian practice.

By signing below, I acknowledge that I have read and understand the eligibility requirements and certify that I am the owner or authorized caretaker of the dog identified in this application.