SAFE's Desexing & Microchip Mission: Securing Futures, Saving Lives.

SAFE collects personal information from you in order to provide you with our services, information about our services and answer any enquiries that you may have. In certain circumstances, we may be required to collect personal information from third parties, depending on the nature of your enquiry, for example from vets.If you provide us with personal information, for example your name, address, email, phone number or other information, we will collect the information in order to assess your application for our service.

If SAFE does not collect this personal information for such purposes, then SAFE will be unable to process your enquiry or supply you with information in relation to your enquiry.

SAFE may share your information with third party service providers who assist SAFE in providing its products and services to you (such as vets, marketing service providers, IT service providers and contractors); and any other organisation covered in SAFE’s Privacy Policy. SAFE will also be providing personal information to Local Government Authorities every quarter to ensure compliance with the Dog and Cat Act.

If you provide us with the personal information of others, we encourage you to inform them that you are disclosing that information to SAFE and why, that they can access that information if they wish and that SAFE does not disclose the information to third parties other than those noted above and within SAFE’s Privacy Policy.

You can access our Privacy Policy here, or contact us at operations@safe.org.au or write to us at PO Box 1390, Karratha WA 6714, to request a copy.

Thank you for reaching out about participating in SAFE's Desexing & Microchip Mission: Securing Futures, Saving Lives, funded by the DPIRD Animal Welfare Grant. Please fill out a separate form for each animal accessing the program. *Terms and Conditions are at the end of the form. Fields marked with a are required and must be accurate to ensure correct microchip registration.**
TELL US MORE ABOUT YOU
Your First Name *
Your Last Name *
Address *
Town *
State *
Postcode *
Phone Number *
Email Address *
Concession card number
Please select the concession card(s) you hold
If your concession card type wasn't in the choices above, detail here.
Nearest SAFE Branch *
How many dogs/cats do you have at home? *
TELL US MORE ABOUT THE PET YOU WANT DESEXED AND OR MICROCHIPPED: Please submit a separate application for each animal you are requesting desexing assistance for.
Animal Name *
Date of Birth * If unsure please estimate
Dog or Cat? *	Dog Cat
Animal Breed If known
Animal Sex *	Male Female
Microchipped? *
Microchip Number If pet is microchipped but you are unsure of the number please enter "Please scan"
Photo Please upload a photo of your pet
Approx weight of animal
Desexing and Microchipping costs can range from $300 to $600. If you can contribute at all towards the procedure your support helps SAFE’s Desexing & Microchip Mission: Securing Futures, Saving Lives DPIRD grant reach more pets in need. If you can contribute at all it would be greatly appreciated but it is not a condition on accessing the funds.
If you are able to contribute towards the procedure, how much can you contribute? * If you can not contribute please type 0
TERMS AND CONDITIONS: - All applications will be considered until grant funds have run out.
I have read and accept the terms and conditions above *
After you have completed this application, please click SUBMIT to send your application to SAFE Inc. Once received we will be in contact very soon via email.