CSDA Recruit Raiser Application

CSDA Recruit Raiser Application

Personal Information

First Name

MI

Last Name

Address Line 1

Address Line 2

City

Country

State

Postal Code

Phone

Email

Preferred form of communication

TextEmailPhone

Age

Date of Birth

Are you, the applicant, 18 years of age or older?

YesNo

If you are a minor, who is the adult that will oversee the process and provide support as needed? (Include guardian's full legal name)

Guardian's Email

Guardian's Phone

Who will be primarily responsible for care and training of the recruit?

Household Information

Do you rent or own your home?

RentOwn

If you rent your home, do you have permission from your landlord to have a dog? (If owned select "does not apply")

YesNo

Is your yard fenced?

YesNoDo not have a yard

Please describe your home and yard.

Please list all HUMAN members in the household. If any children please list their ages.

Are all members of the household interested in becoming a recruit raiser, and willing to comply with our procedures?

YesNo

Are any members of the household allergic or scared of dogs?

AllergicScaredNeitherBoth

Have you ever had a puppy/dog before?

I have raised a puppy beforeI have only had older dogsI have never had a dog before

Do you have any dogs?

YesNo

Is your dog(s) spayed/neutered?

Dog(s) is intactDog(s) is spayed/neuteredFemale ONLY is intactMale ONLY is intact

Does your dog(s) get along well with other dogs?

YesNoDepends

Please list all ANIMAL members in the household. Please list species. For dogs please list age, and gender.

Please describe a typical day in your household:

Please describe what a typical day will look like for a recruit in your household:

Program and Policy

Do you have a preference on a puppy or older dog (2years)?

PuppyOlderEither

Realistically, when is the soonest you can take on one of our recruits?

Puppies, as well as older dogs need socialization. How many times per week can you reasonably take your puppy/dog out for field trips?

1-3x per week3-5x per week5x or more per week

Training is an important aspect of raising a service dog. Are you willing to commit to at least 1hr of training with your puppy/dog everyday?

YesNo

Are you willing to commit to at least 2 monthly meetings with one of our trainers? (With the recent pandemic we understand some people would prefer to social distance. CSDA will accommodate virtual sessions, as well as take precautions in person with masks, gloves, at least 6ft distance apart, and regular sanitization).

YesNoYes, but due to COVID-19 I am only comfortable with virtual sessions for now.

Are you aware that puppies pee, poop, jump, bite, chew stuff, get up early, require frequent potty breaks, bark, whine, cry, require training, go to the vet a lot and are all kinds of wonderful if you can be patient and enjoy this puppy phase?

YesNo

Are you willing to commit to using positive reinforcement training techniques with your recruit?

YesNo

Are you willing to accept our Foster Swap policy? (Every 3 months all puppies will be swapped between fosters to help with their training and help them be able to acclimate to new environments and situations)

YesNo

Why do you want to be a Recruit Raiser?

How did you hear about us?

TYPED SIGNATURE: I have read the following documents and agree to abide by all terms and conditions outlined (By typing your name below you agree).

Contact Information