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Pet Pals Patch Program Request
Please fill out the following request form and we will reach out within a week.
Questions? Email tlunsford@humanecharlotte.org
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* Indicates required question
Troop Leader/Contact Name
*
Your answer
Email
*
Your answer
Phone number
Your answer
Troop Number
Your answer
Please select your first choice of a date
(we suggest Tuesdays 4:30-6pm):
*
MM
/
DD
/
YYYY
Please select your first choice of a time on the above date (between 10:30-6pm Mon-Sat and 11-4pm Sun):
*
Time
:
AM
PM
Please select your second choice of a date:
*
MM
/
DD
/
YYYY
Please select your time on the 2nd choice date (between 10:30-6pm Mon-Sat and 11-4pm Sun):
*
Time
:
AM
PM
Any other dates/times that work for your troop, please list them here:
Your answer
Number of children (max 12):
Your answer
Age range:
Your answer
Workshop topics of interest:
Pet Care 101
Breed ID
Safety Around Animals
Community Service and Advocacy
Other:
Any other information we need to know?
Your answer
I understand there is a fee of $10/child M-F and $12/child Sat-Sun and am willing to pay at the time of registration.
*
Yes
Required
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