Application - Puppy Raiser  Logo
  • Puppy Raiser Application

  • ACTS - Assistance Canine Training Services
    2928 East Conway Road
    Center Conway, NH 03813
    603-383-2073

  • IMPORTANT INSTRUCTIONS:  Please read carefully

    Please use your TAB key to move on to the next entry box.

    You must fill out this entire form in one session.  If you leave your form will NOT be saved.

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  • Dog Training Experience

  • Household Occupants

     

    Please list the names, ages, and relationships of all household members.

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  • References

  • Your references should help us decide if you have the character we require to receive one of our dogs. You should select people who are NOT your immediate family. Choose references who can specifically speak to your character, your previous volunteer experience, your willingness to learn and take on a challenge, your ability to fullfill commitment, or your abilities as a dog owner are particularly helpful.

  • First Reference

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  • Second Reference

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  • Third Reference

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  • I acknowledge that by submitting my name and signing below, that all the above information is accurate and that I fully understand all the conditions presented above.

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