Funding Request Form
Service Dogs Credit Union donates around $10 million per year for service animals in the United States
Applicant Information
Full Name
First Name
Last Name
Contact Number
Please enter a valid phone number.
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization Name
Disability and Need for a Service Dog:
Specific disability, its impact on daily life, required service dog tasks, healthcare professional info.
Living Situation
Housing stability, landlord permission (if applicable), household support.
Financials
Amount Requested
Medical Documents and Pictures
File Upload
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Commitment
I certify that the information provided in this application is true and accurate to the best of my knowledge. I understand that providing false or misleading information may result in the rejection of my application. I also understand that upon approval of this application, funding for a service dog is guaranteed by Service Dogs Credit Union, contingent upon my commitment to fulfill all associated financial obligations as outlined by the program. I promise to comply with all financial responsibilities required to receive funding for a service dog.
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