Live Trap Loan Request
Name
*
First Name
Last Name
E-mail
example@example.com
Phone Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Driver’s License Upload
*
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Driver’s License Information: A copy of your driver’s license is collected solely for identification and security purposes while an MCWR live trap is in your possession. Your driver’s license information will be retained only until the borrowed trap is returned to Marley’s Castle Wildlife Rescue. Once the trap has been returned, the uploaded driver’s license image will be permanently deleted from our records.
Cancel
of
Once contained, how will the animal will get to the MCWR clinic in Holly?
Please Select
I can transport the animal to the MCWR clinic in Holly
I will need MCWR to pick up the animal
Safe Trapping & Handling Education
Infographic / educational guide
Are you comfortable proceeding?
*
Yes
No
MCWR Representative’s name:
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
MCWR Trap Loan Terms & Conditions
Signature
*
By signing below, I confirm that I have read, understood, and agree to the terms and requirements of the MCWR Live Trap Loan Request in the preceding section.
Submit Request
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