Volunteer Application, ATD + CCC, Wagging Tails Brigade Dog Therapy Program

Volunteer Application Wagging Tails Brigade Dog Therapy Program

Please complete this Volunteer Application if you are interested in becoming a volunteer of the Wagging Tails Brigade at Philadelphia International Airport. Thank you.
Today's Date*
Full Name*

PrefixFirst NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Last four (4) digits of your social security number*
xxx-xx-2222
Home Phone Number

Area CodePhone Number
Cell Phone Number*

Area CodePhone Number
Email Address*
Emergency Contact Name*
Emergency Contact Phone Number*
Occupation
Employer
Employer Phone
Languages Spoken
How long have you been a member of Alliance of Therapy Dogs or Comfort Caring Canines? *
What other certification/registration therapy dog program(s) do you belong to?
Please list any other organizations where you and your dog have volunteered and for how long at each?
What are your other interests or hobbies?
What days between 9am - 9pm are you available for a two (2) hour shift?*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Are you able to commit to a minimum of two 2-hour shifts each month? *

Name of Dog 1*
Breed/Description*
Age of Dog*
Weight*
Sex*
Spayed/Neutered?*
Name of Dog 2 (if applicable)
Breed/description
Age of Dog
Weight
Sex
Spayed/Neutered?
Veterinarian Name*
Veterinarian Phone Number*

Area CodePhone Number
Veterinarian Address*

Street Address

Street Address Line 2

CityState

Zip Code
Date of last veterinarian exam*

MonthDayYear
Date
Please describe any physical or medical restrictions for your dog. *
(e.g., epilepsy, heart problems, arthritis)
Is your dog on any medications for these conditions? *
Are you the owner of the dog?*
How long have you had the dog?*
Where did you get your dog (breeder / shelter / rescue)?*
How old was your dog when you got him/her?*
Is your dog house broken?*
Does your dog respond well to basic obedience commands? *
Did you attend a formal obedience class and graduate together? *
If so, please provide the name of the Instructor

First NameLast Name
Contact information of the instructor

Business name

Street Address

CityState

Zip Code
Phone Number of instructor

Area CodePhone Number
Has your dog received any obedience or therapy dog awards?
If so, please list the awards.
How would your dog respond to a busy Airport environment to include: loud noises, elevators, sudden crowds, unexpected hugs from children, being accidentally bumped into, intercom announcements, wheeled luggage, electric carts, etc.?*
Please describe any positive traits of your dog.*
Please describe any negative traits of your dog.*
Has your dog ever been asked to leave a facility?*
If yes, please explain?
Has your dog ever bitten another person or dog?*
If yes, please explain?
Please feel free to include any other information that you would like us to know.
Wagging Tails Brigade Volunteer Service Agreement and Release. Please sign the agreement along with a witness signature and email to leah.douglas@phl.org.
Please attach copies of the following CURRENT documents:
ATD or CCC Membership Card

Click Here to Attach Proof of Membership

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Proof of most recent Veterinary Vaccinations

Click Here to Attach Proof of Vaccinations

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Driver's License, State issued Photo ID, or Passport

Click Here to Attach Driver's License, State Issued Photo ID, or Passport

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Certifications for Training, if applicable

Click Here to Attach Certifications for Training

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To submit your application, click on "Preview Answers" and click on "Submit Application."

Thank you for your interest in the Wagging Tails Brigade.
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Volunteer Application Wagging Tails Brigade Dog Therapy Program