Žiadosť o poskytnutie finančného príspevku pre:   Ukrajinských chovateľov/majiteľov psov, ktorí museli utiecť z UA so svojimi psami
(vyberte vyhovujúce)       Ľudí, ktorí prichýlili u seba ukrajinských psov (bez ich majiteľov)


Meno žiadateľa:  
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Adresa na Slovensku - ulica, číslo:  
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PSČ, mesto:  
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Potvrdenie o registrácii (dočasné útočisko v SR):  
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 (PDF, JPG, max 1 MB)  
 
Adresa na Ukrajine:  
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e-mail:  
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telefón:  
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príspevok vyplatiť na účet (IBAN):  
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Plemeno Pohlavie Meno psa Číslo zápisu Narodený Číslo čipu Status
1.      
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2.      
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3.      
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4.      
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5.      
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6.