Puppy Raising Application

Freedom Paws Assistance Dogs
Puppy Raising/Fostering Application

* Indicates required field

Name *

First

Last

Address *

City, State, Zip Code *

Email Address *

Phone Number *

Age *

Gender *

Employer/Occupation *

Other Members of Household (include name, relationship, and age) *

How long at present address? Do you own or rent? *

Do you have an enclosed yard? *

Yes No

If not are you willing to adapt the yard to make it safe for a puppy? *

Yes No

Do you understand Freedom Paws puppies cannot be off leash unless in an enclosed area? *

Yes No

Please briefly describe your home, yard, and living environment: *

Will you be able to take the Freedom Paws puppy to your workplace? *

Yes No

If you raise a Freedom Paws puppy, where do you plan to have it sleep at night? *

How much time per day are you able to spend socializing and working with the Freedom Paws puppy? *

Please list all dogs currently in your home (include breed, age, altered/unaltered, temperament) *

Please list the name and address of your veterinarian you have selected for the Freedom Paws puppy. *

What are your primary reasons for wanting to raise a Freedom Paws puppy. *

Do you have experience working with people with disabilities? *

Yes No

Please describe your feelings about returning the puppy to Freedom Paws for advanced training and then placement with a person with a disability? *

Is there anything else you would like us to know about you? *

Are you willing to raise any puppy, regardless of breed, color, or sex? *

Yes No

Are you willing to pay for all veterinary care of the Freedom Paws puppy? *

Yes No

Are you willing and able to pay for feeding and other basic care of the Freedom Paws puppy? *

Yes No

Are you able and willing to pay for all transport expenses for the Freedom Paws puppy to and from the training center? *

Yes No

If application is accepted, when will you be ready to raise a puppy? *

Please note at this time Freedom Paws is only accepting puppy raisers that will be willing to be financially responsible for the puppy. *

I agree

To the best of my knowledge, the above information is true and accurate, I agree to provide additional information upon request.By submitting this application electronically, I agree that the name on this application has the same effect as if I signed a hard copy of this application. *

I agree

Applicant Signature *

Date *

If you have not heard from us within 24 hours after submitting this application please check your Junk email, or try emailing us at applicants@freedompaws.org *

Option 1 Option 2 Option 3

Freedom Paws Assistance DogsPuppy Raising/Fostering Application

Freedom Paws Assistance Dogs
Puppy Raising/Fostering Application