Enrollment Request Form
When you are ready, complete the initial application for a team member to be in touch to complete a full application. Once approved, you will be added to our waitlist!
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is the best way to contact you?
*
Please Select
Phone
Email
Either
What type of training are you interested in?
*
Please Select
Emotional Support
Therapy
Specialized Service
Do you have any public service experience?
*
Military
First Responder
Health Care
Education
None
Are you willing to share a medical diagnosis with us?
*
Please Select
Yes
No
Not Applicable
Only required for service training
Tell Us About Your Home Lifestyle
*
Single Family House
Townhome
Apartment/ Condo
ADA Compliant
Children (0-10)
Children (11+)
Additional Animals
Additional Information
Is there any other information you think would be helpful for us to consider?
All the information provided is true and complete. I understand that The K9 Comeback Project have the right to refuse my enrollment application.
*
Yes, I agree and acknowledge
Opt-In To Marketing and Future Events Email
*
Yes
No
Submit
Should be Empty: