Legal Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

List the best number for us to contact you with

(###)

###

####

Date Available *

List the date you are available to begin working

MM

DD

YYYY

Canine Handling *

Select all that apply

I have never worked with dogs in a professional setting but would like to learn

I have experience breaking up violent and potentially fatal altercations between canines

I am mildly intimidated by some dogs

I have previously worked as a professional in the canine handling or caretaking industry

I am uncomfortable working with extremely large dogs on a consistent basis

I am able to consistently lift large dogs (over 70 lbs) at least 5 feet from the floor

I have experience professionally handling uncooperative dogs who want to bite me

Date Graduated *

Or projected graduation date

MM

DD

YYYY

School Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Employer Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Starting Date *

MM

DD

YYYY

Ending Date

MM

DD

YYYY

Supervisor's Phone Number *

(###)

###

####

May we contact this employer for references? *

Yes

No

Employer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Starting Date

MM

DD

YYYY

Ending Date

MM

DD

YYYY

Supervisor's Phone Number

(###)

###

####

May we contact this employer for references?

Yes

No