Online pets registration - The Eastern Townships SPA - Shelter

Caretaker Identification

First Name *

Last Name *

Date of Birth *

Email *

Phone Number *

EMERGENCY phone number

Who is reached at this number (you, friend, etc.)?

Address *

City *

Postal Code *

Is your mailing address different from the one above? If so, please enter the address you receive your mail at.

Animal Description

You would like to register:

Cat

Dog

Name *

Attach a photo of the animal (gif, jpg, jpeg, png)

Choose File

Breed *

Colour *

Distinctive Signs *

Gender *

Male

Female

Date of birth *

Does your pet have a microchip? *

Yes

No

Microchip Number

Has your pet already been registered with the SPA de l'Estrie in the name of another guardian? *

Yes

No

Identification number (tag number)

Is your pet spayed or neutered? Please provide proof to receive the discount. *

Yes

No

Attach proof of sterilization (to obtain the discount)

Choose File

I declare that all of the above information is complete and accurate and that I am aware that any false declaration on my part may result in the issuance of a statement of offence. The Société protectrice des animaux de l'Estrie reserves the right to conduct verifications without prior notice.

I agree with the above statement

Your full name *

Date *

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