Facility Coordinator Registration Form

Important! Please enter your information carefully - extra spaces, especially leading spaces, or not filling in all fields, will generate an error message.

General Information

Address Information

Contact Information


  • I am a Facility Coordinator of a facility visited by Pets On Wheels volunteers.
  • I agree to receive emails from Pets on Wheels.
  • I have read and agree to the Facility Coordinator Responsibilities .

*Failure to meet the terms above will result in your ineligibility to participate with Pets on Wheels.