Therapy Dog Program • Community Site Inquiry

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First Name

Last name

Position/Title

Work Street Address

City

State

Zip +4

Please enter Zip Code +4. Example: 81432-1234

Work Phone Number

Mobile Phone Number

Work Email

Date

Are you a school?

YesNo

ABOUT YOUR SCHOOL

School Name

What school district are you in?

What grade level(s) would we be working with?

Is the principal supportive of this initial inquiry?

YesNo

ABOUT YOUR ORGANIZATION

Are you a nonprofit organization?

YesNo

Organization

What is your organization's mission?

How long has your organization been active in the San Diego area?

What population(s) do you serve?

Has your organization/school collaborated with other therapy dog programs?

YesNo

List other therapy dog programs

YOUR PROGRAM IDEA

NOTE: Our therapy dog programs do not involve the typical "meet and greet" interactions between participants and the dogs. Instead, we design goal-directed programs where we collaborate with community professionals (teaches, counselors, attorneys, etc.) to help their population achieve customized goals.

Why are you interested in a Therapy Dog Program?

Preferred physical location of the program:

Your organization/school locationThe Pawsitive Teams Training Center

Frequency of program sessions

Duration of each session

Preferred day(s)

SundayMondayTuesdayWednesdayThursdayFridaySaturday

Preferred time of day for start and end time.

Preferred Program Start Date

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