Assistance Request Form
FANS of WCRAS is 100% donation driven and using stories about what we do funds our ability to help people and their pets. Our stories use the name of the pet and photos or videos. The family's name is never used. By accepting assistance from us, you hereby grant FANS of WCRAS permission to use your story (anonymously), photograph(s), and/or video(s) in any and all of its publications or on the internet, whether now known or hereafter existing. You will make no monetary or other claim against FANS of WCRAS for the use of the photograph(s) and/or video(s). Please send at least 3 photos of your pet to
fansofwcras@gmail.com
for future use.
* Required
Name
*
Your answer
Phone
*
Your answer
e-mail
*
Your answer
Address
*
Your answer
City, State, Zip Code
*
Your answer
Referred by
Your answer
Type of Assistance Requested:
*
Medical
Pet Deposit
Training
Other:
Required
Type of Pet
*
Dog
Cat
Other:
Pet's name
*
Your answer
Explanation of the issue
*
Your answer
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