MyImpactPage - Peninsula Humane Society & SPCA

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Account

Username

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Username must not end with space

Username must not have two or more spaces in a row

Password

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	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Confirm Password

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	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Name Fields

First NameRequired
Last NameRequired

Address

Address line 1Required
Address line 2
CityRequired
Country Required
State / Province Required
Zip / Postal CodeRequired
Email Address Required

Phone Numbers

Required Please enter at least one phone number

Home Phone
Work Phone
Work Extension
Cell Phone
Phone Preference

Text Messaging

I want to receive text messages on my cell phone.
Cell Phone Number

Misc Fields

Region

Pet Food Bank Information

Pet 1: Name/ Nombre del Mascota

Required

Species / Especie

Required

Weight / Peso

Required

Dry Food Needed (Kibble)/ Necesita Comida Seca/ Croqueta?

Required

Wet Food Needed / Necesita Comida de Lata?

Required

Litter Needed / Necesita arena para gatos?

Required

Allergies or Special Requests / Su mascota tiene alguna alergia o usted tiene una petición especial?

Pet 2: Name / Nombre de Mascota

Species / Especie

Weight / Peso

Dry Food Needed (Kibble)/ Necesita Comida Seca/ Croqueta?

Wet Food Needed / Necesita Comida de Lata?

Litter Needed / Necesita arena para gatos?

Allergies or Special Requests / Su mascota tiene alguna alergia o usted tiene una petición especial?

Pet 3: Name / Nombre del Mascota?

Species / Especie

Weight / Peso

Dry Food Needed (Kibble)/ Necesita Comida Seca/Croqueta?

Wet Food Needed / Necesita Comida de Lata?

Litter Needed / Necesita arena para gatos?

Allergies or Special Requests / Su mascota tiene alguna alergia o usted tiene una petición especial ?

PHS/SPCA Pet Food Bank Agreement

To receive pet food, applicants must:

Be a resident of San Mateo County and experiencing financial hardship
Agree to use the food bank for personal companion animals in need.
Agree to provide address verification and attend the food bank in person.
Agree to not to sell, give away, or return to a store any pet food or supplies received through the pet food bank. This will result in your membership being terminated.
Understand assistance is meant to be a supplemental source of food and not the sole source of food for their pet(s) each month.
Understand that food is donated to PHS/SPCA, and the same brand or type of pet food cannot be guaranteed each month.
We reserve the right to refuse service to any member.
We are providing a service to the community and ask members to take only what they need and not what they can get because it is free.
Enroll no more than three pets per household and agree not to add pets after enrollment.

I agree with the Pet Food Bank Policies

Required

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