Name *

First Name

Last Name

Pronouns *

She/Her

He/Him

They/Them

Other

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What board and train program are you hoping to enrol your dog in? *

Puppy Prep School

Respite Boarding (0-3 weeks)

Skills Camp (4-16 weeks)

Long Term Board and Train (4 months+)

Dog sex *

Neutered male

Intact male

Spayed female

Intact female

Under what circumstances do you currently let your dog off-leash? *

My dog does not go off leash

In fully fenced areas (ex. dog park, backyard)

In un-fenced areas (ex. beach, trails, local soccer field)

How is your dog's recall? Be very honest. We use this information to keep your dog safe and determine an appropriate training plan. *

Has not been trained yet

Not super great (dog has selective hearing, or still a work in progress)

Good unless there is a super exciting distraction (another dog, wildlife, etc)

Very reliable (will recall off dogs/play/wildlife/humans)

Does your dog ride well in the car? *

Yes, they don't mind it

They sometimes struggle (mild nervousness, carsickness, etc)

They really dislike car rides (moderate to severe anxiety, carsickness, etc)

Can your dog be safely left alone in the crate for up to 3 hours? If you are still in the process of crate training, please answer this question honestly and fill in details above. *

Yes

No/not yet

Does your dog display any of the following behaviours? Please be honest and check all that apply, even if your dog shows a mild version of the behaviour. These questions will help Alliance Service Dogs make training plans, keep your dog safe, and will not automatically exclude you from services. *

Separation anxiety (difficulty being left alone or away from their human)

Resource guarding toward dogs or humans (freezing, showing teeth, swallowing, clamping down on, and or growling when you or another dog comes near objects/food they have)

Anxiety/shyness around other dogs (barking, lunging, cowering, running away from, pinning ears, etc)

Anxiety/shyness toward strange humans

Anxiety/shyness in certain environments/toward certain objects/stimuli (ex. scared of garbage trucks, gets anxious on TTC, etc)

Overexcitement/hyperarousal around other dogs (jumping, whining, pulling on leash, biting leash/human, planting/anchoring, barking, etc)

Overexcitement/hyperarousal around other people

Overexcitement/hyperarousal in certain environments or toward certain objects/stimuli

Unwanted greeting behaviours (inability to listen, jumping, whining, pawing, pulling, etc)

Strong desire to chase squirrels, birds, moving objects, etc

Alert barking (at strange humans, strange noises, certain objects such as garbage trucks, doorbells, etc)

Demand barking (attention seeking barking when the dog is not getting what they want)

Difficulty walking on a loose leash

Difficulty settling (relaxing)

Gear sensitivities/shyness

Handling sensitivities

Other

My dog does not display any of the above behaviours

I understand that by submitting this application, I am giving consent for my personal and health information, held in strict confidentiality by Alliance Service Dogs, to be shared with Alliance team members who are not my instructor in order to discuss and determine my eligibility for the board and train program. *

I understand that in order to be accepted into the board and train program my dog must be up to date on the following vaccinations: Rabies, DHPP or DA2PP combination vaccine (Distemper, Parvovirus, Adenovirus (Hepatitis), Parainfluenza), Bordetella (kennel cough), and Leptospirosis. *

I understand that in order to be accepted into the board and train program my dog must be on an approved brand of flea and tick preventative during the entirety of their board and train (examples of approved brands include, but are not limited to: Simparica Trio, NexGard, Bravecto, Vectra 3D, and K9 Advantixx). *

I have answered all of the above questions to the best of my knowledge. *