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STERILISATION REQUEST FORM
Want to sterilise animals in your area? We want to help you!
TO BE ELIGIBLE FOR STERILISATION
Each animal must be in good overall health, at least 4 months of age, and males must have descended testicles. If the animal is owned, the owner must give permission for the animal to be sterilised.
STEP 1: Enter details and clear photos of each animal you want to sterilise.
Complete an entry for each animal. If more than 1 animal, click "Add Next Animal" for each entry
*
Photo of Animal #1
*
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Required
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Photo of Animal #1's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #2
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Required
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of
Photo of Animal #2's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #3
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Required
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of
Photo of Animal #3's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #4
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Required
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of
Photo of Animal #4's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #5
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of
Photo of Animal #5's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #6
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of
Photo of Animal #6's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #7
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of
Photo of Animal #7's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #8
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of
Photo of Animal #8's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #9
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of
Photo of Animal #9's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #10
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of
Photo of Animal #10's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #11
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of
Photo of Animal #11's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #12
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of
Photo of Animal #12's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #13
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of
Photo of Animal #13's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #14
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of
Photo of Animal #14's Vaccination Book
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Skip if no vaccination book or if unknown
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of
Photo of Animal #15
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of
Photo of Animal #15's Vaccination Book
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Choose a file
Skip if no vaccination book or if unknown
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of
STEP 2:
A few more details needed to get the process started
Who is the Contact Person to coordinate this Sterilisation Event? (must be in Bali and able to attend the event in person)
*
First Name
Last Name
Contact Person Phone Number
*
Include Country Code, i.e. +62 812 44444444
Email Address
example@example.com
Hosting a Sterilisation Event requires a covered and private space to protect the team and the animals from weather and close to where the animals live (unless the pet owners / caregivers can transport the animal to and from the event). Do you have a suitable space available for the event to take place?
*
Yes
No
If yes, please enter an address and a Google Maps pin for the private, covered space where your Sterilisation Event can be hosted. Include any accommodation names or landmarks as finding exact locations in Bali can be tricky.
Example: Villa Bali, Jalan Raya no. 123, Cepaka, https://goo.gl/maps/RPcVwQKaHJA2
If you're unable to provide a private, covered space, please enter a Google Maps location pin or detail on where these animals live.
Example: Banjar Pande Cepaka
What else should we know about your Sterilisation Event Request?
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