Pets for Seniors Enquiry Form

To make sure we send you the right information, we need to know a few things about you, and whether the information is for you or somebody else. If you have any questions please contact us with a specific query.

Please fill in all of the fields below.

Contact details

Title
Full name

Telephone

Address
Country
Postcode

The information requested

Are you asking for this information for yourself, or on behalf of someone else?
I would like this information for myself
I am asking on behalf of someone else

Please answer this question to let us know that you are not a machine

What is the result of 7 doubled?

THANK YOU SO MUCH FOR ENQUIRING ABOUT OUR PETS FOR SENIORS SANCTUARY PROGRAM! WE HOPE YOU WILL JOIN US, SOON.

By giving us your email and telephone number you are giving permission for Pets Niagara to contact you by these means with updates and information on how you can help with this program and our other programs.