THE SCIENTIFIC RACCOON JOURNAL

A New Dog - Bringing Raccoons in from the Cold in Urban Areas

Register a Raccoon Supervisor with Supervisor's Short Form One

Supervisor's Name and Contact Information Last Name: First Name:

Street Number: Street Name: Suite/Unit Number:

City: Canadian Province: Postal Code:

Business Phone: Cell Phone: Email Address:

Name and Address of Appointing Hamlet Ring (Council) and Its Ringmaster (Hamlet Mayor) Hamlet Number (if known): Hamlet Name:

Hamlet Street Number: Hamlet Street Name: Hamlet Suite:

Hamlet City: Hamlet Province: Hamlet Postal Code:

Hamlet Phone Number: Hamlet Email Address:

Hamlet Ringmaster's Last Name: First Name:

Supervisor's List of Number of People and Hamlets Involved Number of Feeders Supervised (Maximum Six): ....................

Number of Handlers Supervised (Maximum Six):...................

Total Number of People Supervised (Maximum Six):.............

Number of Hamlets Involved (Maximum Six):.......................

Names of Hamlets Involved if More than One (Up to Six Maximum) 1. Name of Hamlet One:..........

2. Name of Hamlet Two:..........

3. Name of Hamlet Three:.......

4. Name of Hamlet Four:.........

5. Name of Hamlet Five:..........

6. Name of Hamlet Six:...........