About You - Pre Application for a DBL Facility Dog

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Below is a series of questions to help us get to know you better. We ask that you answer these questions with as much information as possible as it will help us better understand your needs.

Yes, I have read the Frequently Asked Questions and watched the video.

Recipient Information

IMPORTANT: If you are filling this application out on behalf of another person, please fill in their information in this section.

Recipient's First Name

Recipient's Last Name

Recipient's Email

Mailing Street

Mailing City

Mailing State

Mailing Zip Code

Mobile Number (i.e. xxx-xxx-xxxx)

Profession

Job Title

I (recipient) currently have a dog living in my home:

Please fill out this section only if you are submitting this application on behalf of the person who intends to be the primary handler.

Are you filling out this form for someone other than yourself?

If yes, please explain:

Submitter's First Name

Submitter's Last Name

Submitter's Email

Submitter's Mobile Number (i.e. xxx-xxx-xxxx)

Facility Information

Name of Facility

Address of Facility

Work Phone Number (i.e. xxx-xxx-xxxx)

Work Email

How did you hear about Dogs for Better Lives?

What led you to consider applying for a Facility Dog?

How do you envision incorporating a dog into your workplace?

How do you plan using the dog’s trained skills to support the individuals you serve?

Please describe your work environment and the population you serve.

In what ways would having a Facility Dog make a difference with those you serve?

Tell us a little about yourself. What would you like us to know about you to support you and your application?

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Contact Information