Nights and Weekends Volunteer Application Name * First Name Last Name Email * Cell Phone * (###) ### #### Work Phone (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth * Where did you hear about Service Dogs of Virginia? * Why do you want to become a volunteer? * Besides giving the dog back to SDV, what do you think you will find most difficult about this work? * Is there anyone in your family with a disability? * Please provide the NAME, ADDRESS, EMAIL, and PHONE number of a personal reference. This must be someone who does not live with you: * Do you have a fenced yard or other fenced area where a dog can get exercise? * Yes No If you answered “No” to the fenced yard question above, do you have access to a fenced area where you can exercise the dog? List below all animals that are part of your household (living indoors or out) and describe the temperament of each. How do they behave around other dogs (including dogs they don't know)? If you have dogs, are they spayed/neutered? Are you a student, stay at home parent, retired, work part-time or work full-time? * Describe your daily schedule (i.e., time you get up, go to work/school, other activities, bedtime, etc.): * What is your occupation? Where is your place of employment? * If needed, would you be able to bring the service dog to work with you? Yes No Please list the name, relation, and age of members of your household (include spouse/partner): * Are all members of your household willing to participate in caring for a service dog and willing to work towards maintaining the dog's training at home? * Yes No How much exercise can you give the dog on the weekends/days not at the center? * Are you willing to purchase toys, treats, and simple equipment for the dog? * Yes No If you are out with a dog in public, are you comfortable talking with people about your dog and what you are doing? * Yes No Do you agree to pick up, clean up, and dispose of the dog’s waste when he/she eliminates in public? * Yes No Have you ever trained a dog before? If yes, what method of training did you use? * Are you willing to learn a completely new approach to training dogs and discontinue using your previous methods? * Yes No Will you be able to drop off and pick up the dog at the Service Dogs of VA training center (673 Berkmar Ct, Charlottesville, VA) Monday through Friday (generally drop off by 9:30 am and pick-up between 5 and 6pm)? * Yes No SDV is closed for the following holidays: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, Day after Thanksgiving, Christmas Eve – New Year’s Day. Are you willing to keep the service dog at home during these times? Yes No Our dogs in training have regular vet visits at Charlottesville Veterinary Hospital, are you able to take the dog you are housing if needed? SDV covers the cost of veterinary care for dogs in training. * Yes No Thank you so much for submitting an application to be a Nights & Weekends Volunteer for Service Dogs of VA! We will get in touch with you as soon as we can to discuss any questions about your application and discuss next steps.
