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* 1. Name

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* 2. Do you live in the Ottawa Valley and are able to attend training weekly in Petawawa/Pembroke

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* 3. Do you have a Dog

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* 4. Tell us more about your dog. Age, Breed, Training (obedience)

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* 5. Do you have a Doctors note stating you would benefit from the use of a service dog. 

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* 6. What task training will you require of your dog

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* 7. Are  you Military or Civilian

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* 8. Contact email you can be reached at

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* 9. Explain what tasks you will require your dog to do.

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