Department Application

This form is for departments, private detection programs, and training organizations that are applying for dogs with working potential.

Department or Organization Name

Organization Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Representative Name

First Name

Last Name

Email

Phone

(###)

###

####

Canine Discipline

What job(s) will the dog participate in?

Canine Restrictions & Requirements

Provide any size, age, breed, or temperament restrictions and any specific temperament or drive evaluations needed for your organization.

Is the your organization training the dog?

Yes

No

If no, who is responsible for training the dog?

Please provide the name and contact information for the organization that will be training the dog.

Veterinarian Name

Veterinarian Phone

(###)

###

####