Pet Food Bank Pilot Project

Pet Food Bank Registration

I understand that:

The VCSPCA Pet Food Bank (PFB) is to provide short term, emergency support for pet parents. I may access PFB once per calendar month. Food will only be distributed in person to people registered and may not be picked up by someone else. Food received through our PFB is for personal use only and can not be sold. Selling of food will result in removal from program. Participation in the PFB is granted at the discretion of the VCSPCA. Terms and conditions are subject to change without notice. Food availability is not guaranteed. Must be a resident of Victoria County.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City Province Postal Code

Phone(Required)

Email

Pet- check all that apply

1st Cat

Spayed/Neutered

Cat's name

Please include preferred food (subject to availability)

Pet-Check all that apply

2nd Cat

Spayed/Neutered

Cat's name

Please include preferred food (subject to availability)

Pet-Check all that apply

1st Dog

Spayed/Neutered

Dogs's name

Please include preferred food (subject to availability)

Pet-Check all that apply

2nd Dog

Spayed/Neutered

Dog's name

Please include preferred food (subject to availability)

I understand that by submitting this form for approval, I acknowledge that I have read and understood the terms above and have voluntarily accepted them and certify that the information submitted is true and correct.

Name(Required)

First Last

Date(Required)

Please provide us with any additional info we may need:

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