NYSWRC  New York State Wildlife Rehabilitator List Signup

Complete this form to submit your name to our on-line list of New York State rehabbers.   If you are already listed and just need to change something you don't need to fill out this form, just send an e-mail to our webmaster

This form is for licensed wildlife rehabilitators located in New York State only.   Please be sure to keep your information up to date.

Just complete this form and click on SUBMIT when ready to send.   

DEC Region
County
Town:
Name:
Are you affiliated with a local not-for-profit wildlife rehabilitation organization or center? Name of organization or center:
Link for your website or website of your organization:
Email Address:
Phone
Alternate Phone
License:	Assistant Class 1 Class 2
	RVS Certified? Oil Spill Training? License to Collect and Possess?
Animals accepted:	Large Mammals Small Mammals Raccoons Skunks Bats Raptors Song Birds Waterfowl Game Birds Reptiles/Amphibians Non-Migratory Birds
Other information regarding animals you accept or special knowledge or skills you are willing to share
State License # (required)
Federal Migratory Bird License #

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