Puppy Raiser Application

Puppy Raiser Application
Full Name*

First Name Last Name
Phone*
E-mail*
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Do you have a secure enclosed yard?*

YesNo
Do you live in:*
Other
Please Specify
Do you have a fenced yard where a dog can get exercise?*

YesNo
If you answered "No" to the fenced yard question above, are you able andwilling to leash walk our dog on a regular basis?

YesNo
Raising a service dog is a 12 to 20 month commitment, an advanced dog could be up to two years. Are you able to make this commitment?

YesNo
What is your previous experience with dogs?
How many puppies have you raised/trained?
Do you have a preference in breed, gender, or color?

YesNo
If Yes; Please Explain
Would you be able to bring your puppy to work/school with you?

YesNo
Will you be able to swap dogs for training?

YesNo
Should be Empty: