Dr. Elsey’s Shelter Program and Shelter Kits

We hope these kits can be used to help cats remain at home and not enter the shelter. The Shelter Kits are also a valuable tool to ease the transition from the shelter to a new home. Shelter kits are for 501c3 shelters only.

Shelter Kit Request Form

To register your shelter for our program we require your tax determination form (501c3) and a noncash charitable contributions tax form (8283) that is then to be returned to us.

SHELTER/RESCUE INFORMATION
Shelter/Rescue Name*
EIN (Employer Identification Number)*
Primary Account Contact*
First Last
Primary Account Email*
Primary Account Phone*
Shipping Address*
*No PO Boxes

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Tax Determination Letter (501c3)*
Max. file size: 100 MB.
Please download and fill out ONLY Section A. 1a. and Section IV on page 2 of Tax Form 8283 (name, address, signature, etc.).

Attach completed form to application under 8283 Tax Form.
8283 Tax Form*
Max. file size: 100 MB.
Signature*
The undersigned acknowledges that the Dr. Elsey’s Shelter Kits are to be used for intervention for shelter cats experiencing litter box issues. The purpose of the coupons in the Shelter Kits is to aid in adoption, and not intended to be redeemed by the shelter or to be auctioned off as a fundraiser. If Dr. Elsey’s finds that the kits are misused they will discontinue sending to that shelter. Shelter Kit orders can be placed once every 30 days.
Authorized Shelter Representative Date
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Shelter Kit Request Form

SHELTER/RESCUE INFORMATION

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