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APPLY FOR A DOG
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About Us
Leadership Board
Services
Get Involved
Jobs & Internships
Support
Contact
APPLY FOR A DOG
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Puppy Raising Questionnaire
Puppy Raising Questionnaire
Step
1
of
6
16%
Full Time Puppy Raiser
Occupation
(Required)
Business Name
(Required)
Business Street Address
Business City
(Required)
Business State
(Required)
Business Postal Code
Business Telephone
(Required)
How many days and hours are you employed weekly?
(Required)
Do you feel that you can handle a young dog in training in addition to your everyday responsibilities?
(Required)
(Required)
Full-time Puppy Raising
Which state do you live in?
(Required)
Choose
New Hampshire
Massachusetts
Rhode Island
Connecticut
Maine
Vermont
New York
New Jersey
Outside New England
If you're outside of New England, where are you located?
Are you willing to travel for outings? (Please note that we are located in New Hampshire, however, outings and puppy classes may take place in different areas based on where puppy raisers are located. There will also be a virtual component to provide additional support to puppy raisers.)
(Required)
Yes
No
Personal Information
First Name
(Required)
Last Name
(Required)
Street Address
(Required)
City
(Required)
State
(Required)
State
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
MA
ME
MD
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
AS
DC
FM
GU
MH
MP
PW
PR
VI
Zip Code (5 digit)
(Required)
Phone Number
(Required)
Mobile Phone
Email
(Required)
How many members in your household?
(Required)
1
2
3
4
5
6
7
8
9
10
Number of children in your household
(Required)
Children's ages
What is the best time to contact you and how?
(Required)
In case of emergency, name a relative we can call if we could not reach you
Emergency Contact First Name
(Required)
Emergency Contact Last Name
(Required)
Emergency Contact Phone
(Required)
Emergency Contact Relationship
(Required)
Emergency Contact Relationship
Spouse
Father
Mother
Brother
Sister
Aunt
Uncle
Cousin
Friend
Other
Are you willing to provide your date of birth for a background check?
(Required)
Yes
No
Birth Month
Birth Month
1
2
3
4
5
6
7
8
9
10
11
12
Birth Day
Birth Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Birth Year
Birth Year
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
Training Experience
Do you have previous puppy raising or dog training experience?
(Required)
Yes
No
Are you willing to take field trips and go to places that are not part of your normal routine and follow FRSD rules for training?
(Required)
Yes
No
Do you have any physical limitations that might affect your ability to train a dog?
(Required)
Yes
No
If yes, please explain.
Please describe any other dog experiences you have had, particularly any positive or negative.
Are you willing to provide progress reports and meet regularly for training sessions with the Puppy Program coordinator? (Full-time Puppy Raisers take weekly obedience classes and check in monthly)
(Required)
Yes
No
How soon would you be able to commit and how flexible is your schedule?
Living Environment
Do you own or rent?
(Required)
Own
Rent
Do you have a fenced yard?
(Required)
Yes
No
Describe your home and yard and any potential safety issues for a dog
Are you willing to have an FRSD representative do a home check?
(Required)
Yes
No
Other Information
On average, how many hours would the pup be left alone each day, if at all? (Please enter numbers only)
(Required)
How did you hear about FRSD?
Why do you want to help us raise a FRSD puppy?
(Required)
Do you have a reliable computer and do you readily use email?
Do you have reliable transportation?
(Required)
Yes
No
Would you be willing to post updates about your puppy in training on social media? (Instagram, Facebook, etc)
(Required)
Yes
No
What are your hobbies/interests?
(Required)
Is there any other information you would like to provide?
(Required)
Submit Questionnaire
By checking this box, I attest that all information in this application is true and correct to the best of my knowledge.
Comments
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