ISF Emergency Medical Grant for Animals Application

ISF's 2017 Medical Grant Program is currently closed. However, we are still accepting Applications. Any Applications received now will be considered for our 2018 Grant Budget.

Applicant Information

2 MB Maximum
Files must be less than 2 MB.
Allowed file types: gif jpg png txt rtf html odf pdf doc docx ppt pptx xls xlsx xml.

Animal Information

Applications may be for one or multiple animals. Explain in detail.
If date is unknown, please estimate
If animal has not yet received medical treatment or will require additional medical treatment, please indicate the date treatment/surgery is scheduled
50 Words or less
100 Words or less
$
$2000 maximum allowed per grant
2 MB (Please combine all receipts and estimates into one file) Please make sure a official veterinary estimate or unpaid receipt is uploaded here. Any other documents, including an additional photo of the rescued animal, can result in an automatic deny of the application.
Files must be less than 4 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx ppt pptx xls xlsx xml.

Treating Veterinarian Information

Please provide the following contact information for the veterinary clinic treating the aninal:
Please CALL YOUR VET TODAY and give ISF permission to speak with your vets office regarding this application and animal. Note, if there is no authorization when a member of ISF's grant team calls, the application WILL BE DENIED.

Photo Upload & Release

Please review the following photo release before submitting your photo:

I hereby grant to the Ian Somerhalder Foundation (ISF), its affiliates, and each of its directors, officers, employees and agents, successors, licensees and assigns, the worldwide, perpetual and irrevocable right to use photographs uploaded here and taken by me or of me and my property in connection with the ISF Grant Programs (the “Program”) and to edit and use said photography and/or other likenesses in the production, distribution, promotion, advertisement, and marketing of ISF and/or ISF’s Purposes in perpetuity. I authorize ISF, its assigns and transferees to copyright, use and publish the same in print and/or electronically and I agree that they may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

I confirm that any and all material furnished by me for this Program is either my own, or is otherwise authorized to use in connection with the Program without obligation to me or any third party.

I hereby waive any right to inspect or approve the photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photographs.

I hereby agree to release and hold ISF, its employees, agents, and assigns harmless from and against any claims, damages or liability arising from or related to the use of the photographs, including but not limited to any re-use, distortion, alteration, or use in composite form, either intentionally or otherwise, that may occur or be produced in production of the finished product via electronic or media means.

I am 18 years of age and I am competent to contract in my own name. If I am not 18 years of age or older, a parent or legal guardian has agreed to this waiver on my behalf. If a child is pictured and is 18 years of age or under, I grant permission for ISF to use the image.

I have read this release before agreeing to it below, and I fully understand the contents, meaning, and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to agreeing to it below, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

2 MB Maximum
Files must be less than 4 MB.
Allowed file types: gif jpg jpeg png.

Applications will only be processed when you click "Submit." Once submitted, receipt of your application will be confirmed via email which will include a Submission number for your reference. If you do not receive a confirmation email, be sure to check your junk mailbox. Please allow up to 7 days for ISF to review your application. Once your application has been reviewed, ISF will contact you directly via email or telephone.