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  Your Location Home New Member Entry  
 
New Member Entry
 
 
 
 

Please fill in the form below with your personal details. Once you have completed this form please press the "Continue »" button which will lead you through to a confirmation screen and then the option to register a pet.

* Please note that fields with a red asterisk (*) beside them require information.

Microchip No:

 

Please only enter numeric or alphabetic  characters                                               

Petsafe Collar Tag No:

 

Clinic ID No:

 

Owner's Details

Title   Given Name                Last Name
Name   * *
     
     Unit    Street No   Street Name
Address  
Suburb    * State: PCode:
Victorian Suburb  
    If you are in Victoria then select your suburb from the above drop down list. If you are outside of Victoria no selection is required.
     
Tel (H)   * Tel (W): 

Mobile

            Fax:
e-mail address  
     
Alternative person       Tel: 
     
Choose Your
Petsafe Password
  *
Re-Enter Password   *
    The password can contain a combination of letters & number both in lower case and upper case. Please limit password to no more than 12 characters.

Pet's Details

Pet's Name   Species:  Dog Cat Other
Colour        Breed: 
DOB   / /  Sex: M F  Desexed: Yes No
DD     MM     YYYY
Savage Dog  
Join Petsafe Mail List  
To learn more about "Opting In or Out", click here

PLEASE NOTE: Registration may take up to 15 seconds.