Facility Dog Application (Individual Ownership)

JLAD will keep your entire application confidential. Your pictures and written application will become the property of The Joys of Living Assistance Dogs.

Please review the application instructions before completing this form.

Your application will be reviewed, and an interview scheduled when all information has been received.

Part A - Client Application, completed by client

Part B - Photo Outline

Part C - Not Applicable

Part D - Financial Plan for the dog

Should you have any questions regarding this application process please call us at (503) 551-4572 or email us at info@joydogs.org.

I'm applying for:

A JLAD Facility DogThe Owner Trained Facility Dog program

Application Part A

Primary Handler

Legal First Name

MI

Last Name

Date of Birth

MM/DD/YYYY

Sex

MaleFemale

Primary Phone

Email

Other Phone

Address Line 1

Address Line 2

City

Country

State/Province

Postal Code

Secondary Handler (if applicable)

Legal First Name

MI

Last Name

Date of Birth

MM/DD/YYYY

Sex

MaleFemale

Primary Phone

Other Phone

Email

Address Line 1

Address Line 2

City

Country

State/Province

Postal Code

Facility Location

Facility Name

Main Phone

Address Line 1

Address Line 2

City

Country

State/Province

Postal Code

What is your position at this facility?

How long have you worked here?

How long have you worked in your field?

How did you learn about JLAD?

Where will the dog reside?

Primary HandlerSecondary HandlerFacility

What is the clientele the dog will be working with? (i.e. children, adults, elderly, abuse victims, developmentally disabled, physically disabled, therapy patients, etc.). Please describe what disabilities or behaviors the dog would need to be comfortable with.

Other than the primary facility location, are there other locations the dog will be accompanying you for work (i.e. courthouses, residential homes, other facilities, parks, etc.)? If the clientele at these locations they will be working with is different than listed above, please list here.

How often do you plan to take the dog to work with you? How many hours of the day will the dog be actively working (i.e. in therapy visits, interacting with clientele, attending court sessions, etc.)?

What are your expectations of the dog? What would be beneficial for the dog to do?

What will a typical day look like for a dog that works with you?

What recreational activities will the dog accompany you in doing?

List the people that will be living with the dog, including their ages and their relationship to you if it is a home residence. Alternatively, please describe the clientele the dog will reside with if living in a facility.

Please describe the dog's place of residence (i.e. home, facility, multiple stories, yard space, etc.).

Is there yard space?

YesNo

What is the approximate size of the yard? (i.e. 50'x50')

Is the yard fenced?

YesNo

How high is your fence? (i.e. 5')

If your yard is not fenced, your fence is too short, or needs repair, will you be able to put up a secure fenced area before you receive your dog?

YesNo

The dog must have a quiet place for downtime that will be uninterrupted such as a kennel, bed, or mat. Do you have a designated space for this at the facility? Please describe what this location would look like.

Are there any other dogs that will reside with the dog? Describe type and age.

Veterinarian's Name

Veterinarian's phone number

If there will be another dog, would you be willing to give up that present dog if it cannot get along with a JLAD dog?

YesNo

Explain

What other dogs have you had? Describe what kind and how old you were.

Have you ever re-homed a pet? If so, what was the reason?

On a daily basis, who will handle walking, cleaning up after, feeding, medication, exercising, grooming, and medical care for the JLAD dog?

Does the facility have a designated area where the dog will be expected to toilet? Will the dog be able to have a potty break at least every 4-5 hours? Please describe where and how the dog will be expected to toilet.

Will it be difficult for you to attend placement classes at the JLAD Training Center in Salem, Oregon for five hours a day for 1 week?

YesNo

Application Part B (Photo Outline)

Please provide pictures. Include the following information and label the pictures with your full name. Be sure to address ALL of the items listed below.

Self

Bust-shot

Full-body

Pictures of your home and work environment are critical. JLAD reviews it frequently during the placement process:

When matching teams, to evaluate whether a dog in training fits your lifestyle and your needs.
During custom-training of the dog to meet your needs.

Pictures of your work environment are critical for JLAD to review:

During custom-training of the dog to meet your needs.

Dog's Place of Residence

Interior and exterior, yard space (including any fencing), and your neighborhood (where you might walk with your dog).

If possible, show pictures of any animal with which the facility dog will regularly interact.

Work (if separate from place of residence)

Interior and exterior, yard space (including any fencing), and neighborhood (where you might walk with the dog). If there are multiple places the dog will work, please show the most frequented places or choose locations that would best represent them all.

Work

Interior and exterior, yard space (including any fencing), and neighborhood (where you might walk with the dog). If there are multiple places the dog will work, please show the most frequented places or choose locations that would best represent them all.

Animals

Show pictures of any animal with which the facility dog will regularly interact.

Letter of Approval/Recommendation

If the dog will be working in a public space such as a nursing home, legal office, or school, we will need a letter from your supervisor to both approve and recommend you for utilizing a facility dog in your profession.

(If the dog will be working in a private space such as your own therapy office, the above is not required)

Please have the above letters of recommendation mailed directly to:

The Joys of Living Assistance Dogs, Inc.

PO Box 12023

Salem, OR 97309

or emailed to:

info@joydogs.org