Foster Care Registration Form

Name: ___________________________________________________________

Address: ___________________________________________________________________________

Phone - Home: _________________ Work: ___________________ Mobile: ____________________

E-mail:____________________________________________________________________________

Interested in (please tick):

Size of yard: _________________________________________________

Other pets: __________________________________________________

Are your pets up to date with vaccinations: Yes / No

Own transport: Yes / No

Number of children: _________ Ages: ___________________________

If renting, have you checked with your landlord? Yes / No

Any other information: ____________________________________________________________________

Please send to:

Animal Welfare League Qld Inc

PO Box 3253

Helensvale Town Centre Qld 4212