RehomingWIP2

Rehoming Wildlife Authorisation Application Form

A Rehoming Wildlife Authorisation enables the authorisation holder to acquire and possess wildlife for the purpose of rehoming it. Eligibility to acquire a Rehoming Wildlife Authorisation is limited to shelter managers employed by the RSPCA or an RSPCA shelter (via a nominated contact), or to registered veterinarians operating out of a commercial clinic.

As part of your Rehoming Wildlife Authorisation application, you must submit a rehoming wildlife management plan. You can attach it to this application form. The Guide to preparing a rehoming wildlife management plan is available on the Conservation Regulator website.

Please allow up to 6 weeks for your application to be processed. Your application will be assessed by Conservation Regulator officers. The officers will inspect your property to confirm that you are eligible and that your facilities are appropriate. To ensure your application is processed as quickly as possible:

ensure your application is complete on submission, including a wildlife management plan that addresses all of the criteria outlined in the Guide to preparing a rehoming wildlife management plan
provide as much detail as possible to support your application, including photos and diagrams if they are relevant

Please ensure all fields have been completed. Incomplete applications will not be assessed until all required information has been supplied.

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Applicant's personal details

First name (required) *

Family name (required) *

Date of birth

Email

Phone

Residential address

Street addressStreet address line 2

City

State

Postcode

Postal address is the same *

YesNo

Postal address

Street addressPO Box

City

State

Postcode

Do you hold any other wildlife licences, permits or authorisations? *

NoYes

Please state the licence, permit or authorisation number, species held and number of animals held.

Licence Number

Please list name and no. of each species held.

Have you been convicted of any offence under the Wildlife Act 1975, Wildlife Regulations 2002, Catchment and Land Protection Act 1994, Prevention of Cruelty to Animals Act 1986 or the Wildlife (Regulation of Exports and Imports) Act 1982 or similar interstate or federal legislation during the last 10 years? *

NoYes

Please state the offence, year of conviction and which State the record is held in.

Eligibility for Rehoming Wildlife Authorisation

Only specified persons are eligible to apply for a Rehoming Wildlife Authorisation. Please select which of the following apply to you. You must attach proof of your eligibility.

a shelter manager employed by the RSPCA operating out of an RSPCA facility; a RSPCA shelter (via a nominated contact)a registered veterinarian operating out of a commercial clinic.

Please provide proof of your eligibility. *

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Select files to upload.

Please provide details of your relevant qualifications and experience in wildlife biology, veterinary science, animal husbandry or similar. *

Appropriate facilities for holding wildlife

Appropriate facilities must be demonstrated prior to approval. Please specify the location that wildlife would be acquired and held.

Wildlife management plan

Please attach your rehoming wildlife management plan here *

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Information Privacy

Privacy and Data Protection Act 2014

The Department of Energy, Environment and Climate Action (DEECA) is committed to protecting personal information provided by you in accordance with the principles of the Victorian privacy laws. The information you provide will be made available to any authorised law enforcement agency, used to monitor compliance with licence conditions and used to provide information from DEECA relevant to your licence. Your contact details may also be used by DEECA or its contracted service providers under confidentiality agreements to survey you about your experience with DEECA and seek feedback related to the keeping of wildlife. A secondary permission may not be issued if the information required is not provided. You may access the information you have provided to DEECA by contacting the Customer Contact Centre on 136-186.

Lodgement

As the applicant for this Rehoming Wildlife Authorisation, I agree that by submitting this form I acknowledge that it is an offence under Section 58B of theWildlife Act 1975to provide false or misleading information in, or in connection with, the application for a Rehoming Wildlife Authorisation and I state that the information that I have provided is true, correct and complete.

Signature *

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