Volunteer Interest Form

What is your availability? *

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Morning

Afternoon

Evening

Canine Information
Canine's name *
Name
Breed *
Breed
Age *
Age (Canine must be at least 1 year old to participate)
Canine's Birthday

Month Day Year
Date
Gender *
Veterinarian *
Veterinarian's Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Veterinarian Phone Number *

Area Code Phone Number
How long have you owned your canine? *
Is your canine a rescue? *

Yes No
Is your canine a Canine Good Citizen (AKC)? *

Yes No Yes, Advanced Canine Good Citizen
Does your canine have any other recognitions or awards?
Ex: AKC Trick Level 1
Please provide any additional information you would like to provide Silver Paws.
Please attach your canine's veterinary records containing the dog's rabies vaccination. If you do not have this document at this time you may upload this document before you first canine therapy visit. Thanks!

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Thank you for your willingness to share your canine with others and assist Silver Paws in its mission.
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