COMMUNITY ANIMAL RELIEF STATION

REGISTRATION FORM

Name*

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Contact Number*

Property Location*

Property Description*

Type of Animal Relief you can Provide*

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Number of Animals you can provide relief for*

Duration of Relief*

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Donations of Animal Relief Items (Optional)

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Permission to use Information

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I consent to The Bushfire Foundation Inc using the Information i have supplied for the purpose of distributing it to members of the community for the purpose of offering assistance in an Emergency Situation.

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