Applicant Information
If applying for a child , they must be 14 years or older.
Date:
*
-
Month
-
Day
Year
Date Picker Icon
Applicant’s First Name
*
Applicant's Last Name
*
Co-Applicant’s First Name
Co-Applicant's Last Name
Street Address
*
City
*
State
*
Zip Code
*
Email Address
*
Daytime Phone Number
*
Evening Phone Number
*
Occupation of Applicant
*
Occupation of Co-Applicant
Back
Next
Information about the dog you wish to train
How old is the dog?
*
1
2
3
4
5
6
7
8
9
10
Is the dog you wish to train up to date on vaccinations?
*
Yes
No
Is the dog neutered or spayed?
Do all family members agree to owning and/or training a new or your own dog?
*
Yes
No
Are you a veteran?
*
Yes
No
Which military affiliation?
Have you been diagnosed with PTSD?
*
Yes
No
Are you active duty?
*
Yes
No
Do you also require mobility training?If so please explain your disability
Are you able to attend regular training appointments?
Is your dog friendly with no history of aggression?
*
Yes
No
Do you have a strong connection with your dog?
*
Yes
No
Do you wish to find a dog with assistance?
Is your dog an indoor dog?
Yes
No
Have you ever owned a dog before?
*
Yes
No
Please briefly describe your knowledge of dogs, such as how many dogs you've owned as an adult and your role with these dogs. Do you consider yourself a novice, intermediate or an experienced dog owner.
Back
Next
References
Veterinarian's Name
*
Clinic Name and Doctor Name
Veterinarian's Phone Number
*
Date of last visit
-
Month
-
Day
Year
Date Picker Icon
Reference #1 Name
*
Reference #1 Phone Number
*
Reference #2 Name
*
Reference #2 Phone Number
*
Note: Please call References and let them know In Dog We Trust will be calling
Your interest in a Service Dog
Why do you want a Service dog? (check all that apply) Please note the dog must be trained for a person 14 years or older.
*
Companion/ Stay at home emotional support
Child's Companion
Guard Dog
Gift
Mobility Service Dog Training
Personal Protection
Psychiatric / PTSD Service Dog Training
So I can take my pet into stores and restaurants
Please explain in detail your dog's personality type and energy level Active/Couch potato Elaborate on the reasons why you think training your dog could help you .
*
List the tasks you would like the dog to be trained to do for you. We can help you decide if you're unsure
Are family members aware that the advice you can be given should be taken seriously to ensure success?
*
Yes
No
Have you already approached another Service dog training company? If so which one?
*
Service Dog Express
Other
Back
Next
Care and Training
Please let us know which training company you have already approached and/or will be training with them
*
Where will the dog be kept during the day?
*
Where will the dog be kept at night?
*
Are you familiar with the use of a crate to train and/or confine the dog in your absence or when you are not able to adequately supervise a puppy to keep him/her out of trouble?
*
Yes
No
Does your dog have the run of the house?
*
Yes
No
Is your dog tied outside or live in the yard for long hours at any time?
*
Yes
No
Describe your dog training experience.
*
Are you willing and able to regularly and consistently work with your dog and keep regular appointments with the trainer?
Yes
No
How do you discipline your dog? (Note we only use positive reinforcement training no hitting grabbing etc.)
Have you used a trainer before? tells us why it wasn't successful.
Are you willing to accept homework between sessions and complete it?
Yes
No
Yes
No
We require that all dogs be spayed/neutered prior to training, do you have any questions about this policy?
If you are unable to care for your dog in the future, who will accept responsibility for its care?
Yes
No
Male
Female
Dogs listed on our site in which you are interested if currently do not own one..
Please add any other information that you think might be helpful to us in evaluating your application.
How did you hear about us?
Terms and Conditions
Therefore, I hereby
*
Confirm that I have read, understand, and agree to all terms and conditions stated in the Adoption/Training Policy and Application.
Confirm that all of the information I have provided on this application is true and accurate to the best of my knowledge.
Submit
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform