Please print and take to your Council for a signature.

_____________________________

DAW VERIFICATION FORM

 FOR THE

 ____________________
fill in the name of your Neighborhood Council

 This confirms that

 _________________________________________
name of the DAW

has been appointed to serve as the Director of Animal Welfare (DAW) for our Council.

Signed,

 _________________________________________________
name

 ___________________________________
title

___________________________________
date