REGISTRATION FORM FOR VOLUNTEER KARUNA ANIMAL WELFARE ASSOCIATION OF KARNATAKA

(Formerly BSPCA)

To,The SecretaryKarunaKasturba Road Bangalore – 560 001

Please register me as an Volunteer of the Association

Name : _____________________________ Father/ Husband's Name : ________________ Date of Birth :__________________________ Profession:____________________________ Pets owned: __________________________ Telephone Number: ______________________

I subscribe to the aims and objectives of the Association, and would like to become avolunteer of the Karuna Animal Welfare Association of Karnataka.

(Please tick the sphere of activity you are interested in)

(Please tick the sphere of Activity you are interested in.)

1. Human Education ( ) 4. Prevention of cruelty ( )2. Assistance in shelter ( ) 5. Other Voluntary Work ( )3. Collection of Donations ( ) 6. Any other sphere, kindly state ( )

Date : Signature of the applicant

Affix your Photographs

(2 nos)