Uno's Legacy Retired K9 Assistance Application
Thank you for your interest in Uno’s Legacy. This application is for handlers of retired working dogs seeking assistance.
Uno’s Legacy provides assistance for retired law enforcement and military working dogs (MWDs), who are given priority in our program. We will also consider applications from other certified working K9s on a case-by-case basis.
⚠️ If this is an emergency request, please call or text Brittany at 475-301-6355 available 24/7.
Section 1 - Handler Information
Name
First Name
Last Name
Department/Agency
Phone Number (cell preferred for quick contact)
Please enter a valid phone number.
Email Address
example@example.com
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Section 2: Retired K9 Information
K9’s Name
Breed
Age
Years of Service
YYYY-YYYY
Department/Unit Served
Special Certifications (if any)
Section 3: Current Health & Care
Current Health Concerns or Diagnoses
Current Medications or Supplements
Known Allergies
Veterinarian/Clinic (Name & Phone)
Section 4: Support Needs
What kind of support do you feel your retired K9 may need through Uno’s Legacy? (Example: food, supplements, medical, or palliative care)
Section 5: Care Package & Retirement Life
Favorite Treats
Favorite Toys
Favorite Activities In Retirement (Example: going for walks, swimming, chewing a ball, lounging on the couch, etc.)
Section 6: Uploads
Please upload some photos of your retired K9. These may be used for internal records, care packages, and — with your consent — recognition on our website and social media.
Browse Files
Drag and drop files here
Choose a file
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Section 7: Consent & Signature
Eligibility
*
I certify that the above information is true and that this dog is a retired law enforcement, military, or certified working K9
Privacy & Use of Information
*
I understand that the information provided in this application will be used solely for the purpose of evaluating eligibility and providing assistance through Uno’s Legacy. My personal information will not be shared outside of Uno’s Legacy/Blue Line Jars without my consent
Contact Agreement
*
I agree to be contacted by Uno’s Legacy regarding assistance for my retired K9
Photo/Story Release
*
Yes I give permission for Uno’s Legacy to share my K9’s photo and story on social media or fundraising materials
No I dont give permission for Uno’s Legacy to share my K9’s photo and story on social media or fundraising materials
Signature
Date
-
Month
-
Day
Year
Date
Should be Empty: