Raise a Puppy Application Form – Next Step Service Dogs

Puppy Raiser Volunteer Application

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*NSSD does not condone discrimination with regard to race, color, national origin, religion, sex, age, disability or veteran status in applicants, paid staff or volunteers. All applications will be considered equally.

Puppy Raiser Job Description

As a Next Step Service Dog Puppy Raiser, you will be teaching your puppy about love, trust, bravery, basic obedience, and socialization. As a raiser you and your pup will have public access to the movies, church, theme parks, bowling alleys, restaurants, stores and malls. You will use public transportation like buses, trains, and airports. They can go with you on vacations. You will expose them to all of the things they could encounter as a working service dog, so they become confident and comfortable in any situation.

Puppies are constantly learning during their first year of life! You will enjoy learning our specialized training to teach your puppy basic obedience commands like sit, down, stay, heel, and come.

Becoming a volunteer Puppy Raiser of a future service dog is a 12 to 15 month-long commitment of time, energy, and love. Every day through care and training, Puppy Raisers provide the critical foundation that puppies need to begin formal service dog training. There are few things in this world more heart-warming than seeing your puppy work seamlessly with its teammate knowing that you’ve given someone a level of independence that she or he did not have before.

What is NSSD responsible for?

Vaccinations
Reimbursement of spay/neuter up to a certain amount (to be discussed upon placement)
Training equipment
Provides tools for puppy raisers to be successful
Provide monthly flea medications
Provide microchip
Provide food

What is a Puppy Raiser Responsible for?

Have dog spayed/neutered and given rabies when instructed
Get approval before taking puppy to vet or on trips
Attend an organized puppy class either at NSSD or a local approved program
Notify NSSD if you are unable to take the puppy where you are going and need to have a dog sitter
Administer monthly flea medications
Send monthly reports
Take puppy into public weekly and report behavioral concerns IMMEDIATELY
Turn in the dog at estimated due date with all vaccinations up to date and all paperwork

All Puppy Raisers agree to 4 training sessions prior to first placement.

*After placement, Puppy Raisers agree to attend a training session each week for the first 5 months and then two training sessions per month thereafter.

APPLICANT INFORMATION

Applicant First Name:

Applicant Last Name:

Contact Information

Street

City

State

Zip Code

Home Phone:

Cell Phone:

Preferred Email:

Preferred Email Type

History

Have you raised a puppy within the past 5 years either personally or for another organization?

YesNo

If yes, what breeds and what organizations?

Do you have experience living with and caring for a dog within the past 5 years?

YesNo

If yes, what breeds and ages of dogs?

Do you have any pets in your home?

YesNo

If yes, what kind, breeds and ages?

Is your dog(s) accepting of other dogs in your home?

Availability

Please list possible training dates (MWF) 9:30am-11:30am in Escondido which you wish to attend (to see training and dogs, two training days within a 1-month period are required):

Enter dates your would be available. Example: 10/16/2020

Can you commit to 2 training sessions in a one-month period prior to placement?

YesNo

Are you available for trial dog sitting (using a crate and following NSSD guidelines)?

YesNo

DOG BEHAVIOR QUESTIONS

What are some ways to correct or redirect a dog if he barks?

If the dog jumps on people?

If the dog whines?

Under what circumstances would you punish a dog?

What would the punishment be?

How much praise should a dog receive?

What are some ways to reward a dog?

This is a 4 page application. At any point in time you can click on the Save my progress and resume later checkbox at the top of the page. You will then enter an email address and password. You will receive an email with a link to come back and complete the form.

Page 2

NSSD VOLUNTEER AGREEMENT

Please read the following:

In order to maintain our liability insurance, we have the responsibility to support certain standards of conduct for our volunteers. A signed copy of the below volunteer guidelines must be on file in the NSSD office.

VOLUNTEERS MUST AGREE TO ALL OF THE FOLLOWING:

Agree that they are not considered employees of NSSD unless contracted as an independent contractor.

Agree to provide proof of valid driver’s license and automobile insurance. Alternatively volunteers may indicate that they agree not to drive on behalf of NSSD including for transportation to all meetings. Auto liability coverage must be at least 100/300.

Agree to carry health insurance for themselves.Maintain confidentiality about clients, personnel, and organizational operations.Understand that NSSD insurance covers them when conducting NSSD business, and thus must agree to conduct themselves in a careful and professional manner.Understand that NSSD liability insurance will not release them from liability if they willfully damage another’s person or property.Be prepared to educate the public upon request on the benefits received by a person with a disability using canine assistance and to inform them of NSSD and ADI Program Standards & Ethics.Transporting clients in personal vehicles is not permitted unless they have special licensing from the state, have liability insurance covering them as a professional driver, and provide NSSD with an “additionally insured” statement from their insurer.Abide by the law while under the auspices of NSSD. Volunteers who refuse to, or fail to, adhere to these standards will lose authorization to volunteer NSSD.I agree to a background check.I AGREE WITH THE STATEMENTS ABOVE.

Applicant E-Signature

Date (mm/dd/yyyy)

Page 3

NSSD WAIVER AND RELEASE

I HEREBY WAIVE AND RELEASE, indemnify, hold harmless and forever discharge, Next Step Service Dogs, Board of Directors, Trainers, Staff and their children, volunteers, agents, employees, officers, directors, affiliates, trusts, successors and assigns (hereinafter referred to as the “Released Parties”), of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I ever had, or may have, arising from, or in any way related to my participation in any of the events or activities conducted on the premises of the Released Parties.

I understand that the activities that I may participate in are inherently dangerous and may cause serious or grievous injuries, including bodily injury, damage to personal property and/or death. On my behalf, and on behalf of my heirs, assigns and next of kin, I waive any and all claims for damages, injuries and death sustained to me, or my property, that I may have against the aforementioned Released Parties to such activities.

By this WAIVER & RELEASE, I assume any and all risk attendant to the premises, and take full responsibility for, and waive any and all claims of personal injury, death or damage to personal property associated with any and all activities conducted on the premises.

This WAIVER & RELEASE contains the entire agreement between the parties and supersedes any prior written or oral agreements between the parties concerning the subject matter of this WAIVER & RELEASE. The provisions of this WAIVER & RELEASE may not be waived, altered, amended, or repealed, in whole or in part, except upon the prior, written consent of all parties.

The provisions of this WAIVER & RELEASE will continue in full force and effect even after the termination of the activities conducted on the subject premises, whether by agreement, by operation of law, or otherwise.

I have read, understand, and fully agree to the terms of this WAIVER & RELEASE. I understand and confirm that by putting my initials next to this paragraph and that by initialing this WAIVER & RELEASE that I have given up considerable future legal rights. I have read and agree to this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me whatsoever. My initials are proof of my intention to execute a complete and unconditional WAIVER & RELEASE of all liability to the fullest extent of the law.

Applicant E-Signature

Date (mm/dd/yyyy)

NSSD PHOTO VIDEO AND RELEASE

Please read and check the box below:

In exchange for no consideration received, I hereby give permission to Next Step Service Dogs, Inc. to use my name and photographic likeness in all forms and media for promotion, advertising, trade, and any other lawful purposes.

Applicant E-Signature

Date (mm/dd/yyyy)

NSSD CONFIDENTIALITY POLICY

Please read the following:

Respecting the privacy of our applicants, clients, donors, members, staff, volunteers and of the organization itself is a basic value of Next Step Service Dogs. Personal and financial information is confidential and should not be disclosed or discussed with anyone without permission or authorization from the Executive Director.

Care shall also be taken to ensure that unauthorized individuals do not overhear any discussion of confidential information and that documents containing confidential information are not left in the open or inadvertently shared. Applicants, clients, donors, members, staff, volunteers, and board members of Next Step Service Dogs may be exposed to information which is confidential and/or privileged and proprietary in nature. It is the policy of Next Step Service Dogs that such information must be kept confidential both during and after employment or volunteer service.

Applicants, clients, donors, members, staff, volunteers, including board members, are expected to return materials containing privileged or confidential information at the time of separation from employment or expiration of service. Unauthorized disclosure of confidential or privileged information is a serious violation of this policy and will subject the person(s) who made the unauthorized disclosure to appropriate discipline, including removal/dismissal. Please note, all applicants, staff and volunteer records will be kept confidential in a locked file.

Please check the boxes below:

I agree to abide by the requirements of this policy and inform the Executive Director immediately if I believe any violation (unintentional or otherwise) of the policy has occurred. I understand that violation of this policy will lead to disciplinary action.

I further commit to following NSSD Policies & Procedures and safeguard the mission and processes of Next Step Service Dogs.

Applicant E-Signature

Date (mm/dd/yyyy)

Page 4

NSSD ORGANIZATION STANDARDS

Please read and check the boxes below:

I consent to a background check and a home visit.

Please read and check the following carefully before signing this application:

I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with NSSD that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by NSSD. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with NSSD or my termination as a volunteer.

Applicant E-Signature

Date (mm/dd/yyyy)

On the next page you will be given the opportunity to review/edit you application. Be sure to click CONFIRM at the bottom of the page when you are ready to submit your application.

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