22Mohawks Pups for Vets & First Responders Application
22Mohawks Pups for Vets & First Responders program is for companion dogs and we offer CGC or basic obedience training depending on your location.

This is not a service dog or therapy dog program.

Please fill out ALL INFORMATION on this form and be sure to check your spam and other inboxes for next steps email as they sometimes get sent there.

Contact stacey@22mohawks.com with any questions. 
Sign in to Google to save your progress. Learn more
Email *

Full Address - Town - State - Zip Code
Date of Birth
Branch of Service OR First Responder Division 

Military service dates or First Responder start date

MOS or Job Title

ETS Date

Do you have any disabilities? PTSD, TBI, depression, cancer, physical impairments etc. if yes, please list how symptoms/severity impacts daily life.

Disability Rating if applicable 

Spouse if applicable and number

Current Employer and number 

How Many Adults over 18 in household
How Many Children under 18 in household

Please list ages of adults and children as well as any special needs/disabilities etc:

Rent or Own home? Describe home: Apartment, single family, town house etc 

If rent please, give your landlord’s name and phone number so may verify that you are allowed to have pets: 

Will you need any formal documents to have a dog approved by the landlord?

Do you have backyard? Is it fenced? Height of fence? This is not a requirement for adoption. 

Have you lived with a dog before?

If yes, please describe your experience.

Do you currently have any animals at home?

If so, how many,  type, age, temperament?

If you have a dog currently in the home, what is the main reason for wanting another dog? 

Please note that we only accept certain circumstances on pairing a second dog in the home.
1. If your current dog is elderly.
2. If you and your spouse are both veterans or first responders and the dog belongs to the other spouse.
3. If your current dog has health issues that restrict them from going on walks etc. 

Do all adults in the home work full time?

How many hours a day will the dog be home alone?

How many hours a day will you spend time with your dog?

Where will your new dog be kept when it's alone?

Where will your new dog sleep?

Does anyone smoke with in the home? 

Will you be requesting one of our training programs?

If opting out of training please indicate any alternate plans for training?

Are you ready to receive a pup now? Or is there a timeframe you need prior to taking

Veterinarian’s name and phone number?

Please provide the name and number of a non-family member that we may contact as a reference. 

Please provide the name and number of a person who would "co sign" in you having a pup.

This person would be able to take your pup in the event that something unexpectedly happened that would cause you to not be able to care for your pup for a short amount of time or in the event something happened to you this person would be open to caring for the pup indefinitely or until we could find a new home for the pup.

If you are currently unemployed how will you be providing financial basic care needs for the dog? Monthly Food, Vet care costs can run from $140-200+ for first visit.

If unemployed do you have another person who will commit to helping provide for basic care needs for the dog? If so please list this persons name and number.

Are you able to handle all of the dog's physical needs of daily exercise and care?

If you have any physical limitations please explain. This will not hinder receiving a dog from our program. We want to ensure to pair you with the dog that best meets your needs. 

Would you consider your home environment to be laid back, high energy or even paced? 

Please provide info about your home life that will help us best match you with the perfect pup!

What does a normal day look like for you?

What do you do with your down time?

What activities do you like to do?

What traits are you looking for in a companion pup?

How would you describe yourself?

Do you or have you ever struggled with substance abuse? Drugs, alcohol.

How many drinks do you have per week?

How would you rate everyone’s readiness for a new puppy in your home?

If getting a puppy aged dog have you thought about potty training?

How manageable is the daily stress in your home without a puppy?

What are your stressors?

What stress management skills do you currently have?

Do you have any triggers and what are they? This will help us best identify dogs that may or may not be the best breed for you.

Do you have a good support system? If yes, please list those in your support system.

How would you rate your mental health right now on a scale of 1-10?

Not Good
Clear selection

Optional - This is for internal data, will not be shared and will not effect your application. Do you now or have you had suicidal thoughts/intentions?

Do you currently see a therapist? If so how often.

Would you be interested in our 1:1 or group counseling sessions through 22Mohawks?

Please provide the best day and time of day to schedule a home visit either in person or via zoom.

Please share any other information you find necessary for us to know about yourself and reasons for wanting a dog?

Provide any information that you think will help us pair you with the best match for a pup as we can.

Are you ok with any age dog? If not would you rather a puppy or older dog? 

How did you hear about 22Mohawks? 

Please email a copy of your DD214 and Letter of Benefits or confirmation of your employment if a FR to stacey@22mohawks.com

You can block out your SS# if you wish. We do not need that to process your application. 
By filling out this form you are agreeing to the 22Mohawks Pups for Vets Liability and Terms of Agreements listed below. 

Initial Below.

22Mohawks Pups for Vets Liability and Terms of Agreements

If I receive a dog from 22Mohawks I agree to have a vet check within the first month of taking ownership of the dog if a current vet check was not done prior. Paperwork from the vet appointment will be forwarded to stacey@22mohawks.com if applicable. If unable to acquire a vet appointment within that time frame, a scheduled appointment time must be provided to 22Mohawks.

I agree to upkeep with all vet appointments, shots and needed care for the pup I receive.

I agree to payment of all inquired costs for the dog including daily living, vet appointments and any other costs after receiving the dog. 

I agree to return the dog to 22Mohawks if for any reason the care of the dog can not continue to be fulfilled by the adoptee with a min 7 days notice unless a emergency.

I agree to notify 22Mohawks if the temperament of the dog does not adapt into my lifestyle. At this time an agreement can be made if more specific training needs to be done or we will work to fit you with a dog that better suits your needs.

I agree to regular check ins with 22Mohawks via zoom, phone or in person during the first year receiving my pup.

I agree that 22Mohawks can decide at any time if necessary to cease the dog if signs of neglect, abuse, malnutrition or if there is any appearance or concern the dog is not being properly cared for.

I agree that until the dog is signed off on by a 22Mohawks Master Trainer, 22Mohawks has the right to take full ownership of the dog if signs of neglect or not being able to properly care for the dog are displayed.

We at 22Mohawks take the care of our dogs seriously and want to work with you in all areas to ensure the perfect fit for both you and the dog. We are here to assist in any way. Please do not hesitate to reach out with any questions or concerns.

Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy