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MEMBERSHIP APPLICATION

Please fill out all required fields below and click the submit button to apply for membership as a Doggie Disciples volunteer.

General Information

Is this your full time residence?
Yes
No
Preferred Method of Contact
Call
Text

If retired, please indicate below

Pet Information

Write name exactly as you wish it to appear on the certificate

Dog's Birthday
Month
Day
Year

*Approximate

Sex
Male
Female

*If your dog is a mixed breed, please list primary & secondary breed (if known)

Additional Details

Please Note: Teams must be evaluated by a Pet Partners evaluator and receive certification and insurance through Per Partners.

(i.e. Training classes, prior therapy work, etc.)

(i.e. Pet Partners, Alliance of Therapy Dogs, etc.)

Does your dog have a Canine Good Citizen certificate from the AKC?
Yes
No
In process, but not complete

*Not required to volunteer, but highly recommended if you would like additional training

Which days of the week do you have availability to volunteer? Select all that apply.

*This information helps us determine the best days and times for our volunteers when we coordinate visits

What time of day would you prefer to volunteer? Select all that apply.

*This information helps us determine the best days and times for our volunteers when we coordinate visits

What types of facilities are you most interested in visiting? Select all that apply.
How often would you prefer to make site visits?
1 day / per week
2 -3 days / per week
More than 3 days / per week
2 - 3 times / per month

As a general rule of thumb, we ask that volunteers commit to a minimum of 2 visits per month, however we understand that is not always possible during unforeseen circumstances or for those living in the area part time.

Would you be willing to share this dog with a handler who does not have his/her own dog for practice & therapy sessions?
Yes
No
Undecided
Would you like to help with special events / projects?
Yes
No
Undecided
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