Name *

First Name

Last Name

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

(###)

###

####

Please indicate which of the following activities are of most interest to you: *

Foster home (provide temporary foster care for cats and kittens)

Community Cat Feeders

Mosaic Stadium

Board Member

RCR Member (paid membership allows voting authorization at the AGM)

If you selected "Provide foster care for cats and kittens," do you wish to foster:

kittens only (under 6 months old)

adult cats only (1 year or older)

cats of any age

Would you like to receive our quarterly e-bulletin?

Yes

No

Do you have a valid drivers license and access to a vehicle?

Yes

No