Personal Information

First and Last Name (required)

Telephone (required)

Address (required)

City (required)

State(required)

Zip Code(required)

Your Email (required)

Occupation

Gender
 male female

Backgound Information

How did you hear about Paws’itive Teams?

Please describe your facility and the client population served

What is your position at the facility and the ways you are involved directly with the clients

How long have you worked at this facility?

Describe your reasons for wanting a Facility Dog

Describe your typical day at work

How do you expect working with and having a Facility Dog living with you will affect your life?

Residency and Lifestyle Information

Describe other members in your home.

Are you or other members living in your household allergic to animals? Please explain:

Select your home type:
house condo apartment mobile home

Select your yard type:
un-fenced yard patio fenced yard no yard

Do you or any household member have a dog, other pets or other critters that a dog will need to get along with? Describe

Describe your past relationships with dogs and any experience you have had in training your own or other dogs:

If you have a dog now, where does that dog sleep?:

Have you participated in dog shows, pet therapy or other dog related activities? Describe:

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