Respite 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 * What type of volunteer do you want to be? * Puppy Raiser Nights and Weekends Respite 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 a 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? 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? * Please list the name, relation, and age of members of your household (include spouse/partner): * Do all members of your household want to participate in caring for a service dog? * Yes No If more than one family member is involved in raising the puppy, will you be able to follow SDV’s recommendations on how to divide the training and management of the pup? * Yes No If more than one family member plans to participate in training the pup or taking him on outings, will that person able to attend classes with the primary handler? * Yes No How much exercise can you give the dog each day? * 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 For respite for dog in advanced training: Will you be able to drop off an d pick up the dog at the Service Dogs of VA training center (673 Berkmar Ct Charlottesville, VA) Monday-Friday (generally drop off by 9:30 and pick-up between 5 and 6pm) Yes No For respite for puppy: Will you be able to keep the puppy ta home with you during the respite period? Yes No Do you have a preference for respite? puppy dog in advanced training no prefernce Thank you so much for submitting an application to be a Respite Volunteer for Service Dogs of VA! We will get in touch with you shortly to clarify any questions we may have about your application and discuss the next steps.
