The Joys of Living Assistance Dogs
One moment please...
Puppy Socializer Application
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Phone
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
JLAD requires the primary volunteer puppy socializer to be at least 18 years or older
*
Are you at least 18 years of age?
Why are you interested in becoming a volunteer puppy socializer?
*
In addition to you, who else will participate in raising the puppy?
Name of 1st individual
Age of 1st individual
Name of 2nd individual
Age of 2nd individual
Are there children living in your household?
How many?
What are their current ages?
JLAD requires that the assistance dog / puppy be the only puppy less than 12 months of age living in the household.
Please describe the other animals in your home:
Dogs
How many dogs
Breed
Age- Dog 1
Sex
select one
Male
Female
Spayed/Neutered
select one
Yes
No
Scheduled
Breed
Age - Dog 2
Sex
select one
Male
Female
Spayed/Neutered
select one
Yes
No
Scheduled
Duration of Ownership:
Cats
Number of cats
Breed
Age - Cat 1
Sex
select one
Male
Female
Spayed/Neutered
select one
Yes
No
Scheduled
Duration of Ownership:
Breed
Age - Cat 2
Sex
select one
Male
Female
Spayed/Neutered
select one
Yes
No
Scheduled
Duration of Ownership:
Other Animals
Please use this for additional dogs/cats or other animals
Number of Other Animals
Kind of animal
(i.e. rabbit, horse, etc.)
Age - additional animal 1
Spayed/Neutered
select one
Yes
No
Scheduled
Sex
select one
Male
Female
Duration of Ownership:
Kind of animal
Age - additional animal 2
Sex
select one
Male
Female
Spayed/Neutered
select one
Yes
No
Scheduled
Duration of Ownership:
Any other important information about other pets in your home
Please tell us about your home and yard.
Your Commitment
JLAD requires volunteer puppy socializers to provide the necessities for raising a puppy which include food, water, bowls, shelter, bed, toys, collar, leash, treats, veterinary care due to lack of supervision (i.e. puppy eats a sock & needs surgery)
*
Are you willing and able to provide for the above requirements while raising a puppy?
select one
Yes
No
I certify that either I am a homeowner or my rental unit allows animals
*
select one
Yes
No
I understand I am responsible for any damage caused by my JLAD puppy to my or anyone else's home or rental unit.
*
select one
Yes
No
JLAD requires volunteer puppy socializers to teach toilet training and house manners as well as attend weekly training classes and field trips.
*
Are you able to reliably attend weekly training classes and field trips with the puppy?
select one
Yes
No
As a puppy socializer you will need to provide the puppy with weekly socialization to several environments such as grocery stores, pharmacies, medical offices, restaurants, shopping malls, and if possible, your place of employment.
*
Are you able to include the puppy in weekly activities at least 3 hours per week?
select one
Yes
No
What are the aspects of your household routine, environment and lifestyle that will contribute to the puppy’s socialization?
*
Being a puppy socializer requires a good deal of physical stamina, which includes bending, stooping, lifting walking distances and repetitive motion.
*
Are you prepared to meet the above requirements?
select one
Yes
No
Being a puppy socializer requires patience, emotional control, the ability to learn new concepts and practices, the ability to receive constructive feedback and the ability to work positively within a team
*
Are you prepared to meet the above requirements?
select one
Yes
No
What experience do you have that will contribute to your ability to meet the above requirements?
*
If you will be transporting the puppy in your private vehicle, JLAD Insurance requires that you provide proof of insurance.
Please upload a copy of the front of your (or the household driver) driver's license here
Drivers License State
License Number
Exp Date
(mm/dd/yyyy)
Please upload your automobile insurance card here
Insurance Provider (Required by our insurance):
Additional information here (regarding driving and insurance)
Developing a bond and trust early in the puppy’s life is a very important aspect in the success of our dogs. This human/animal bond and trust is critical to establish early and repeatedly throughout the puppy’s life. We recognize that bonding is highly emotional and letting the puppy transition into another bonding relationship is even more so.
How are you prepared to make this transition from the bond you have established to letting the puppy transition to next bonding experience?
*
Describe your current or past volunteer experience?
*
What was most rewarding about past volunteer experiences?
*
What was most challenging about past volunteer experiences?
*
Provide two personal/professional references who are prepared to speak to your ability to uphold a commitment and work within a team.
Name
First Name
Last Name
Relationship
Phone
Email
Verify Email
Name
First Name
Last Name
Relationship
Phone
Email
Verify Email
When could you start to foster the puppy?
*
(mm/dd/yyyy)
Additional information here
Upload a photo of yourself here
*
A color headshot (head and shoulders) photo of yourself. If you are selected, this photo will be used for your identification badge. (no hat, sunglasses, busy backgrounds or other people/pets)