Good Dog Academy Scholarship Application

This application is for a scholarship to assist with the tuition for one training program hosted by the Humane Society of Southern Arizona. *We do not train animals to be service animals*

Please note: The scholarship recipient will still be responsible to pay a small portion of the tuition.

Scholarships are only for group classes and do not include behavior modification or 1:1 sessions. Behaviors not suitable for a group class environment include biting, anxiety, leash and dog reactivity, separation anxiety, destruction of property, snarling, growling, or attempting to bite other dogs or people. The above are some examples of behaviors that require in-home or 1:1 training sessions.

Please contact vzimmerman@hssaz.org (520.327.6088 ext 153) with any questions.

If no PROOF of financial need, military status, or government assistance is provided, your scholarship application will not be considered.

To submit any supplemental information, please email it to the above-listed email.

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* 1. Please provide the following information

First and Last Name

DOB

Mailing Address

City/Town

State/Province

ZIP/Postal Code

Cell Phone

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* 2. Please check all that apply:
If you are required to show documentation as listed below, your scholarship application will not be processed until the appropriated documents are provided.

I am currently receiving financial assistance from the government (AHCCCS/Food Stamp Program, WIC, etc). Please submit a legible copy of your AHCCCS or Food Stamp Card.

Social Security is my primary source of income. Please submit proof of this income.

My annual income is 30% of the median community income (16,100 for one person, 18,400 for two people, 20, 700 for three people, etc). Please submit proof of this income level.

I am an active duty, veteran, or retired military member.

If you and your family do not qualify for one of the above circumstances, please briefly explain below why you require financial assistance to attend this program.

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* 3. Please submit any supplemental documentation for the question above. These documents can also be sent to the contact information above. If no PROOF of financial need, military status, or government assistance is provided, your scholarship application will not be considered.

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* 4. Please give us a brief description of your financial need.

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* 5. Please give us a brief description of the dog you intend to participate in your selected training class (age, breed, behavior, goals, etc)
Scholarships are only for group classes and do not include behavior modification or 1:1 session. Behaviors not suitable for a group class environment include biting, anxiety, leash and dog reactivity, separation anxiety, destruction of property, snarling, growling or attempting to bite other dogs or people. The above are some examples of behaviors that require in-home or 1:1 training sessions.

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* 6. Is your dog spayed or neutered?

Yes

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* 7. Has your dog previously bitten a person or another animal?

Yes

Please explain:

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* 8. Please select the course you would like to receive a scholarship for:

Mindful Manners

Life Skills 1

Canine Good Citizen

1:1 Behavior Modification

Good Dog Academy Scholarship Application

Question Title

* 1. Please provide the following information

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* 2. Please check all that apply:If you are required to show documentation as listed below, your scholarship application will not be processed until the appropriated documents are provided.

Question Title

* 3. Please submit any supplemental documentation for the question above. These documents can also be sent to the contact information above. If no PROOF of financial need, military status, or government assistance is provided, your scholarship application will not be considered.

Question Title

* 4. Please give us a brief description of your financial need.

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* 6. Is your dog spayed or neutered?

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* 7. Has your dog previously bitten a person or another animal?

Question Title

* 8. Please select the course you would like to receive a scholarship for:

* 2. Please check all that apply:
If you are required to show documentation as listed below, your scholarship application will not be processed until the appropriated documents are provided.