Main Line Deputy Dog APPLICATION

Main Line Deputy Dog APPLICATION
Today's Date

MonthDayYear
Date
Full Name*

First NameLast Name
Birth Date*

MonthDayYear
E-mail*
Cell phone*

Area CodePhone Number
Home or Office phone

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Your diagnosis: physical challenge/ psychiatric concern . How long have you been having these?*
How did your situation/circum-stances develop?*
What tasks would you like your dog to be able to perform for you?
If you have a dog, dog's name/age**
Breed
Dog license
Veterinarian / phone#
Any additional info
We also require the completion of a Physician's Questionnaire and a Veterinarian's Questionnaire**, you will receive these forms at your initial interview.

** A dog you have may or may not be suited for service dog work

Main Line Deputy Dog is an equal opportunity organization and does not unlawfully discriminate against volunteers, students, board members, associates, participants, or applicants for work on the basis of an individual’s race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status or any other status protected by applicable law. This policy applies to all terms, conditions and privileges of work participation, including recruitment, placement, assignment, compensation, promotion, discipline and termination.

Whenever possible, Main Line Deputy Dog makes reasonable accommodations for qualified individuals with disabilities to the extent required by law. Associates who would like to request a reasonable accommodation should contact the Executive Director.

Violations of this policy will not be tolerated.

ELIGIBILITY REQUIREMENTS
Eligibility Criteria:

Applicants must meet the following requirements to be considered for the Main Line Deputy Dog (MLDD) program:

Commit to the Deputy Dog training program for at least one year and up to two years.
Live within 50 miles of program headquarters.
Be able to meet the physical and financial needs of a service dog, including medical expenses.
Be actively pursuing independent living and seeking to improve their quality of life through partnership with a service dog.
Follow all aspects of the application process, complete team training, and abide by all program follow-up guidelines.
Be at least 18 years old or partnered with an adult, both of whom must train together.
Applications will be accepted regardless of race, color, national origin, religion, gender, age, or disability.

Services Provided:

MLDD offers coaching for handlers to fully train dogs to become either mobility service dogs or psychiatric service dogs. Training occurs in weekly classes led by expert dog trainers and behaviorists, supported by volunteers. Main Line Deputy Dog charges a general $75 per month fee for training.

Dog Welfare Expectations:

Dogs must be kept in good health and receive regular grooming.
Students must submit paperwork from a licensed veterinarian verifying that all participating dogs:
Have current vaccinations.
Undergo an annual health check-up.

Application Process & Timeline:

1. Submit an application, available in the “Get Started” section of our website (mldd.org).
2. MLDD will contact applicants via phone or email to set up an informal preliminary interview.
3. Applicants must complete the **long application within three weeks** of submitting the short application.
4. MLDD will review applications and reach out with any follow-up questions.
5. MLDD will contact the provided references.
6. Applicants must observe a class to gain firsthand experience with the program.
7. If the applicant already has a potential service dog candidate, MLDD will evaluate the dog-handler relationship to determine suitability.
8. Applicants with their own dogs must provide full medical history, including vaccinations and veterinary records.
9. If the applicant does not have a dog, MLDD will discuss needs and preferences to match them with a suitable rescue dog.

Right to Withdraw from the Program:

Participation in the MLDD program is voluntary. Applicants and students may withdraw from the program at any time for any reason without penalty.

No Obligation for Public Relations or Fundraising:

MLDD does not require or pressure applicants or students to engage in public relations activities or fundraising efforts on behalf of the organization.
Students are welcome to voluntarily promote MLDD or participate in fundraising, but this is entirely at their own discretion.

This policy ensures that potential applicants have clear, accessible information about MLDD’s application process, services, expectations, and rights, in compliance with Assistance Dogs International (ADI) standards.
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