Application Form

NW SAFE PET CARE LLC Membership Application

Building Trust. Strengthening Professionals. Elevating Ethical Pet Care.
Applicant Name

First NameLast Name
Business Name
Business Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Website
Social Media Links
Business Type

Other
Years in Business
Number of Team Members
Primary Service Area
Membership Level Requested
Applying for Legacy (Founder) Membership
Payment Option for Legacy (Founder) Membership
Applying for Leader Membership
Payment Option for Leader Membership
Applying for Professional Membership
Payment Option for Professional Membership
Interested in Team Member Add-On
Number of Additional Team Members
Preferred Payment Method

Other
Describe Your Business and Services
What Makes Your Business Unique?
What Does Ethical Pet Care Mean to You?
How Do You Support Animal Welfare, Professionalism, and Client Trust?
Do You Currently Maintain Written Policies, Procedures, Standards, or Operating Guidelines?
If Yes, Please Briefly Describe
Are You Licensed, Insured, Certified, or Otherwise Qualified as Applicable to Your Profession?
If Yes, Please Describe
Have You Ever Been Subject to Disciplinary Action, License Suspension, or Significant Legal Action Related to Your Business or Professional Services?
If Yes, Please Explain
Why Are You Interested in Joining NW SAFE Pet Care?
How Do You Hope to Contribute to the Organization?
How Did You Hear About NW SAFE Pet Care?

Other
Areas of Focus
Would You Be Interested in Contributing to NW SAFE Pet Care in the Future?
Acknowledgements
Application Fee $75 Consent
Acknowledgements

I certify that the information provided in this application is accurate and complete to the best of my knowledge. I agree to abide by the NW SAFE Pet Care Code of Ethics and applicable organizational policies if accepted as a member. I understand that membership approval is subject to review and is not guaranteed.
Applicant Signature
Applicant Signature
Date

MonthDayYear
Date
For Office Use Only
Should be Empty:

NW SAFE PET CARE LLC Membership Application

Acknowledgements