Therapy K9 Response Team
The 100 Club of Illinois connects resources for first responder emergency response and refers departments to available resources during times of need. One of those resources is our Therapy K9 Response Team. Please fill out the form below if you'd like to learn more. Thank you!
Handler Information
Handler Name
*
First Name
Last Name
Handler Email
*
example@example.com
Handler Direct Phone Number (cell phone if available)
*
Please enter a valid phone number.
Format: (000) 000-0000.
If the above number is a cell phone number, can we text you for requests?
*
Yes
No
That is not a cell phone number
Other
Handler Department
*
Department Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
K9 Information
K9 Name
*
K9 Breed
*
K9 Gender
*
Male
Female
K9 Size
*
Small: 7-15 lbs
Medium: 15-30 lbs
Large: 30-65 lbs
XLarge: 65+ lbs
K9 Age
*
Please share a photo of your K9!
*
Browse Files
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How long have you had your K9?
Are there multiple handlers of your K9?
*
Yes
No
Thank you for taking time to complete this form!
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