Application to Breed Cats Privacy Statement The Town is collecting your personal information for the purpose of responding to your request. Some of the information may be provided to the Town's contractors for the purpose of addressing your request. Your information will not be provided to any other person or agency unless you have given us permission, or where legally obligated to do so. If you would like to know more about how the Town handles your personal information, please see the Town's Privacy Statement and Collection Notice. --------------------------------------------------------------------------------------------------------------------------------------------------------------------- The Town of East Fremantle may refuse this application if any or all of the required information is not provided within 21 days of lodging the application. Sect 37(3) Cat Act 2011. Please refer to our Schedule of Fees and Charges and be advised that applicants must be over 18 years of age. Applicant Details Full Name of Owner*This field is required. * Required Field. Residential Address*This field is required. * Required Field. Postcode*This field is required. * Required Field. Telephone Number*This field is required. * Required Field. Date of Birth*This field is required. * Required Field. Email*This field is required. * Required Field. Full Name of Alternative Contact*This field is required. * Required Field. Residential Address of Alternative Contact*This field is required. * Required Field. Postcode of Alternative Contact*This field is required. * Required Field. Telephone Number of Alternative Contact*This field is required. * Required Field. Email Address of Alternative Contact*This field is required. * Required Field. Address where cat will normally be kept (if different from above)*This field is required. * Required Field. Name of Cat*This field is required. * Required Field. Date of Birth of Cat*This field is required. * Required Field. Breed of Cat*This field is required. * Required Field. Colour*This field is required. * Required Field. Sex of Cat*This field is required. MaleFemale Microchip Number All cats must be microchipped. You must provide a copy of their current national database microchip certificate in the owner's name. If the microchip is registered to a different name, a transfer of ownership with the database company that the microchip is registered is required before proceeding with this application. If you are unsure which database your cat's microchip is registered to or where to find the certificate, please contact the person or organisation you purchased the cat from.*This field is required. * Required Field. Proof of Microchip - Upload a file here*This field is required. Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Detailed description of breeding arrangements and management of breeding cats and kittens(please also cover disposal of waste, noise control and frequency of customer's attendances) - Upload a file here*This field is required. Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Site Plan (to scale) detailing where cats will be kept on property showing proximity to all structures - Upload a file here*This field is required. Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Details of any Enclosures - Upload a file here*This field is required. Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Membership of Prescribed Organisation*This field is required. COAWAFCCWAANCATS Proof of Membership - Upload a file here*This field is required. Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx Previous Convictions*This field is required. YesNo If yes, please give details, specifying the date of the conviction(s), nature of the offence and legislation involved: * * Required Field. I declare that*This field is required. The particulars on this application are true to the best of my knowledge and belief; andI am aware that it is an offence to provide false or misleading information I agree that once my application has been assessed and an email of approval from the Town has been received, I will contact the Town to make payment*This field is required. Yes Type the code from the image: Do not fill this textbox.