Vancouver Parks Board Stanley Park Children's Farmyard Farmyard Animal Adoption Application

Prior to fillling out this application (3 pages), please read the following: The Vancouver Parks Board is committed to securing safe, permanent, loving homes that will provide: proper shelter, food, water and treatment at all times The Vancouver Parks Board cannot guarantee the age, health or temperament of the animals(s). The Vancouver Parks Board seeks adopters who will not allow the animals (s) to be used for medical or experimental purposes

*Important* Completed forms must be returned no later than January 10, 2011 to:
By Mail: Attn. Corinne Yee-Creaghan,Train & Farmyard Coordinator, Stanley District Vancouver Parks Board 2099 Beach Avenue Vancouver, BC V6G 1Z4 By Email: corinne.yee-creaghan@vancouver.ca By Fax: 604.718.6539 Application Instructions: Please fill out the form completely, using more paper if necessary. 1. Please list the Animal(s) you would like to adopt:

2. Applicant Information Organization Name: First Name: Address: Province: Home Phone: Cell Phone: Last Name: City: Postal Code: Work Phone: Email Address:

3. Name of Employer:

Phone No:

4. Name of Veterinarian:

Phone No.

5. Name of Farrier:

Phone No.

6. List of Farm Animals currently in your care by breed, age, quantity: Breed: Age: Qty:

7. If animal(s) will live on your property, please describe your barn/pasture, etc. (include acreage) and what type of fencing. Indicate if property is rented, owned, leased. Please provide photos.

8. Please indicate whether this is a commercial entity.

Yes

No

9. Please indicate whether this is a registered non-profit entity.

Yes

No

10. Please provide a breakdown of funding sources if your organization receives financial support Ie. List names, term & duration of funding support received, of Government contracts, grants, donations, etc. Funding Source Name: # Years Funding Duration of Present Funding Funding Amount Received

11. If future funding become unavailable, would this impacat the means to financially care for the animals?

Yes

No

12. Please describe how you will be able to provide life-time care of the animals you are interested in adopting?

13. Do you agree to accept full responsibility for caring for animal(s) on a permanent basis and agree not to, breed, sell, trade, loan or use the animal for roping or cruel sports?

Yes

No

14. Are you a current member of an animal organization?

Yes

No

15. If you are a member of an animal organization, please list the name of the organization.

16. Are you available for our staff to visit your property?

Yes

No