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Dogs On Duty Companion Dog Application
Universal Screener for Working Dog Requests
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Email *
First and Last Name *
Phone Number  *
Address (Street) *
City and Zip code *
How long have you lived the current address? *
Tell us about the people that live in your home. Name and age. *
Are you over the age of 18? *
Are you completing the application for someone under the age of 18? If so, what is the name and age of the child you are applying for? *
If selected, do you consent to a background check? *
If selected, I consent to a home visit to verify my address and to ensure that placement would be successful. *
Are you located within 60 miles of O'Fallon Missouri? *
Driver's License or State ID # (Please indicate which state issued the ID) *
What type of working dog are you looking for? *
If you are applying for a service dog, please list the tasks you are looking for the dog to perform. 
If applying for a service dog, please tell us more about your disability. This helps us select the best dog for you. 
If you are applying for a facility/ Therapy dog, please tell us where the dog would be working and the type of work you would like the dog to do?
Are you able to financially provide for a dog? (Vet bill, Food, and grooming needs). *
Are you willing to meet for follow up training? This could be weekly depending on the type of working dog you are applying for. *
Have you ever trained a dog before? *
How would you correct a dog for doing something wrong? *
Where will the dog be when it's not with you? *
How many hours a day will the dog be left alone? *
Who will be the primary caregiver for the dog? *
Have you ever given a pet up for adoption or rehome?  *
How you ever had to ethnize a pet before? *
Are there other pets in the home? If so, please list all pets and their age. *
If you have other dogs, please tell us about their temperament.
If a dog is placed with you, are you willing to complete fundraisers to help offset the cost of the working dog? *
Have you applied for a working dog with any other organizations? *
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