Spay Jax 2026 Application Form Spay Jax Online Application 2026 This form is for individuals interested in qualifying for Spay Jax in 2026. Part One: Owner InformationUpload the 2026 Spay Jax Certificate (PDF)Max. file size: 1 GB. Owner's Name(Required) First Last Owner's Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Owner's Phone(Required)How are you going to qualify for Spay Jax?(Required) Program Income How are you submitting proof of residency for Spay Jax?(Required) FL ID JEA Payment Mortgage Payment Lease Agreement Part Two: Pet InformationWhat is your pet's name?(Required) First What type of pet do you have?(Required) Male Dog (under 75 lbs) Male Dog (over 75 lbs) Female Dog (under 75 lbs) Female Dog (over 75 lbs) Male Cat Female Cat Color(Required)Breed(Required)Age(Required)Please note months and years. (Example: 3 years and 2 months)Has your pet received a rabies vaccine by a licensed veterinarian within one year of today?(Required)Yes; My pet HAS received a rabies vaccine by a licensed veterinarian within one year of today.No; My pet HAS NOT received a rabies vaccine by a licensed veterinarian within one year of today.Part Three: Waiver of LiabilityConsent(Required) I agree to the terms of this waiver.1. The above described pet lives at my home address. I agree that a representative EveryPet may contact me and a schedule a time to come to my home and verify this pet. 2. I attest that the above information is true and correct to the best of my knowledge. 3. I hereby consent to the pre-surgical rabies immunization, if required, and spay or neuter of the pet described above. 4. Animals that are spayed or neutered and vaccinated as a result of the Spay Jax program are the responsibility of the animal owners. I hereby agree that EveryPet, Spay-Jax, the City of Jacksonville, and the veterinarian performing surgery have no responsibility or liability for any injury or damage, or claims subsequent thereto, to any person, property, or animal, caused directly or indirectly by any of the participating parties. 5. I agree to participate in this program and agree to this waiver of liability. By inputting my first and last name and clicking on the consent button, I acknowledge that I have read and agree with the above statements.Name (E-signature)(Required) First Last Date(Required) MM slash DD slash YYYY