Last Litter Program Application

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Pet's Name*

Type of pet*

CatDog

Breed of Pet*

Age of Pet*

Are you the legal owner of the pet? If not who is?*

Has your pet been:*

Vaccinated within the last 12 monthsMicrochippedUnsure

If known how many previous litters has your pet had? This helps us understand how much support she may need.*

If known, please list any health issues your pet may have. This information helps our veterinary team provide the necessary care during her stay with them: *

Please describe your pet's temperament.*

Is the pet currently pregnant?*

YesNo

If the litter has already been born you can apply for this program until the puppies or kittens are 10 weeks old providing you have not rehomed any of the litter. After this age further conditions may apply. Date of birth or age of puppies or kittens.*

Number in litter and their sexes (if known)*

Have the puppies or kittens been wormed? If not Ollie's Legacy can help you with this.*

If known, what is the breed of the father of the puppies or kittens?

Do you need assistance with food and/or other supplies for the mother and her offspring? Please note that we can only assist if we have donations available.

Is there anything further that you would like to add:

Signature

By submitting this application you are agreeing to the following terms and conditions:

I understand this application does not mean acceptance to the Last Litter Program.
I declare the dog/cat is owned by me and I have the legal authority to surrender the litter to Ollie's Legacy Incorporated.
I agree to surrender the entire litter to Ollie's Legacy Incorporated.
I understand that as part of acceptance into this program the cat or dog and their offspring must be of good temperament and able to handled.
I understand that the mother cat or dog must be desexed at a veterinary clinic nominated and paid for by Ollie’s Legacy Incorporated within 4-6 weeks of weaning her offspring.
I understand that If I violate this agreement and do not surrender the puppies/kittens to Ollie's Legacy Incorporated, I will be responsible for reimbursement of medical and/or care related costs the organisation has incurred.
I understand that if the application is successful it forms part of the Last Litter Program Agreement

Last Litter Program

Personal Details