ADL Membership Registration Form

Pawsitism Puppy Raiser Application

Puppy raisers care for our pups in their homes for 18 months. They teach basic obedience skills and health manners and socialize their props to all of the sites and sounds in the world. The puppy raising program is a fundamental part of the journey of a positive and dog; it provides the foundation on which formal service dog training will build.
Today's Date

MonthDayYear
Name*

First NameLast Name
Phone Number*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Why would you like to raise a Pawsitism Inc. puppy?
When would you be ready to begin raising a Pawsitism Inc. pup?
Please list the names and ages of the members of your household? (Please indicate N/A if appropriate)
(Please indicate N/A if appropriate)
Who would be the primary puppy raiser?
Who would take responsibility for the puppy when the person above is not available?
Are all family members willing to contribute to raising the puppy?
Is anyone in your household allergic to dogs?

YesNo
Do you work? If so, where? (Please indicate N/A if appropriate)
Is anyone in your home afraid of dogs?

YesNo
How many hours will the puppy be left alone during the days it is not at the facility?
Where will the puppy be left when it is alone?
Please describe your home, yard and neighborhood. Include whether or not your yard is fenced.
Do you Rent, Own your Home or Apartment?
Do you have other dogs at home?

YesNo
What breed? Age? Sex? Spayed or neutered?
How do your dogs react to other dogs?
Have you ever observed your dog growl, snap, cover, or avoid people or other dogs, for any reason?

YesNo
Does your dog alert bark noises, the doorbell or a knock on the door?

YesNo
How will you handle this?
Type a question

YesNo
If yes, what type? How old are they?
How do they react to dogs?
Have you owned dogs prior to these? If yes, what happened to them?
Are you willing and able to attend classes in advance for training and socializing the puppy?

YesNo
Are you willing to pick up food and transport the puppy to the vet when needed?

YesNo
Would you be comfortable with us making a home visit?

YesNo
Are you willing to adhere to our policy to keep our puppies healthy and safe at all times, this includes completing the checklist given for training and keeping them on a leash unless in a fenced in area, and providing adequate exercise and socialization?

YesNo
What is your experience with dogs-obedience, training, handling, showing, fostering, raising etc.?
Please summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through activities, including hobbies or sports.
How did you hear about us?
Anything else you’d like us to know?
Things to keep in mind for the Service Dog Training Program: Pawsitism Inc., in conjunction with RUFF Academy, will require the puppy to be at the RUFF Academy Main facility 4 days a week, 8 hours a day minimum and will ask the puppy be in attendance for events, field trips and fundraising events throughout the 18 months. RUFF Academy will also have Service Dog School on Wednesday evenings each week. You will be required to attend these classes so you know what to work on to help with the puppy’s training.

I agree to the following:

	Yes
I understand everything I have read above regarding being a Puppy Raiser for Pawsitism Inc.
I agree to what I have read and I want to become a Puppy Raiser for Pawsitism Inc.
If chosen to become a Puppy Raiser for Pawsitism Inc., enter into this Agreement of my own free will and understand that this is a binding contract enforceable by civil law.

THANK YOU for filling out this application. We look forward to speaking with you soon!

Phone: 920-277-7473 Email: pawsitism@gmail.com
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Pawsitism Puppy Raiser Application