Puppy Raiser Application

Name: 

Date:

Address:

Age:

Phone: (H)

(W) 

Email:

Birthdate: 

SS#:

Please list current grade and school or current occupation & employer:

Briefly explain why you are interested in raising a puppy for Promising Partners:

Have you ever raised a service dog in training before? 

Do you have any pets? 

Please list type, breed and ages:

Please list all the people residing in your home and their ages:

Do you own or rent your home? 
If rent, do you have a pet policy?
Include copy of policy or letter from landlord.

Do you have any experience working with animals? 
If yes please explain:

Please describe your home/family and general schedule:

Do you have a fenced in yard? 

If no, are you willing to always walk the dog on a leash? 

Approximately what percentage of the day are you away from home?

Do you travel? 

Where and how often?

Do you understand that all expenses, including food and vet expenses, are the responsibility of the puppy raiser? 

Are you capable of covering those expenses? 

Please have all adults residing in household sign below to acknowledge that each understands the responsibilities that come with raising a puppy for Promising Partners and that they are in support of having a puppy in the home.

Name 

Date

Print out, complete and return questionnaire to:

Promising Partners Assistance Dogs, Inc., P.O. Box 364, Ellinwood, KS 67526.