New Vet Clinic Membership Form

Vet Clinic Membership Form

NEW MEMBERS DETAILS
Welcome to WReNNZ national network for wildlife rehabilitators. We thank you for your interest and active involvement in wildlife rescue, rehabilitation and release and look forward to learning a lot more about you and your work.
Individual's Name*
Veterinarian
Name of Clinic*
Where applicable
Postal Address*
Facilities Address*
Phone*
Mobile
Email Address*
Additional Member
Vet Nurse - Full name and contact details required
By joining you agree to accept and abide by WReNNZ rules. If you would like to, you also have the opportunity to contribute wildlife related articles for potential publishing on WReNNZ website. If you haven't read the document in detail yet, please take the time to review WReNNZ Minimum Standards for Rehabilitators. If you have any queries or concerns please contact us.
Additional Comments
If you have extensive experience and want to be listed on WReNNZ website, please tick yes?

Yes
Name of person completing the form
Date

DayMonthYear
My Membership
prevnext( X )
Vet Clinic Membership($79.00NZD for each year)

Total $0.00NZD
Should be Empty: