Bonita Therapy Dog Training Program Owner Application
Sign in to Google to save your progress. Learn more
Owner's First Name *
Owner's Last Name *
Address *
Cell Phone *
Include area code
BUSD Work Site *
Campus Phone Extension
BUSD E-mail Address
Personal E-mail Address *
Dog's Name *
Breed *
Birthday *
MM
/
DD
/
YYYY
Age *
How did you acquire the dog? *
Breeder, shelter, etc.
Color, markings and size *
How long have you owned the animal? *
Has your dog completed basic obedience classes? *
Proof of completing basic obedience class with Live Oak Dog Obedience is REQUIRED to start the program in the fall. Those who have proof of this class already completed OR are currently enrolled in will have higher priority in the application process. If your dog still NEEDS to take the class contact me to get enrolled with our designated trainer, Maya Quintero with LIVE OAK DOG OBEDIENCE, at a discounted price.
Required
List the commands, behaviors, tricks, etc. that your dog knows.
Is there a specific age group that this animal avoids or seems uncomfortable around?
Check all that apply
Is there a type of individual that this animal avoids or seems uncomfortable around?
Check all that apply
Has this animal ever acted in a threatening or menacing manner towards an individual, group of individuals or animal? *
Threatening/menacing includes: over staring, growling, snapping, snarling, barking at, lunging toward or biting individual or animal. Please write details in "other"
Required
Does your animal have any health problems? *
If so, please explain in detail
What is your dog's favorite game or activity? *
Check all that apply
Required
How do you discipline/correct this animal? *
What does this animal do when it becomes stressed? *
Ex: yawning, excessive blinking, shaking, whining, etc.
What do you do when you recognize that your animal is stressed? *
List any kinds of animals that this animal does NOT react to well. *
What compelled you to participate in this program at this time? *
Why do you think your pet will make a good therapy dog in training with a student at Bonita? *
After the student assigned to your dog has completed the program, are you interested in becoming an official certified therapy team to continue to allow your dog to work with the students at Bonita, volunteer in nursing homes and hospitals, etc.? *
To have the dog to continue to come on campus in the years after the program, you MUST be a registered therapy team
What grade, age, subject, student abilities do you work with? *
What type of interaction do you hope your pet will have with your student population? *
Emotional support, test anxiety, special needs interaction, classroom enhancement, etc.
Equipment and financial responsibilities   *
Please check off to acknowledge you will purchase the following
Required
What behaviors would you like your dog to perfect that they already "kind of" know? *
What behaviors would you like your dog to learn? *
What type of "therapy" do you think your dog will do best at? *
Be as descriptive as possible
Please acknowledge that you MUST have the "Health Screening Form" completed by a veterinarian and turned in by August 1st, 2017 *
Vaccine/Parasite information WITH veterinary proof *
Email copies of vaccine certificates to j.black@bonita.k12.ca.us or deliver documentation to my mailbox at BHS by June 1st, 2017. Check boxes to confirm you have and will send documentation.
Required
Expected scheduling to be done directly with student trainer. *
Please check boxes to confirm
Required
Acknowledge to keep the dog healthy and looking it's best *
Check boxes to confirm and ask me if you need any advice
Required
Acknowledge to providing a "doggy diaper bag" with all the supplies your dog will need *
Check the boxes to confirm
Required
Acknowledge that any of the following will result in removal from the program. *
Check the boxes to confirm
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Bonita USD. Report Abuse
Google Forms