Hero Dogs Puppy Raiser/Sitter Application STEP 1 Please review the general information and requirements for puppy raisers and puppy sitters on our website. If you have remaining questions, please send an email to puppyprogram@hero-dogs.org. STEP 2 If you have not already done so, please fill out a volunteer profile and agreement. STEP 3 When you filled out the agreement in step 2, you created a username and password. Log in now using that username and password, then return to and refresh this page. STEP 4 If you logged in successfully, you should see your contact information already filled in below. Now complete the remainder of the fields on this application and submit. Thank you! Primary Raiser (must be an adult) First Name * Last Name * Street * Street2 City * State * ALABAMAALASKAARIZONAARKANSASCALIFORNIACOLORADOCONNECTICUTDELAWAREDISTRICT OF COLUMBIAFLORIDAGEORGIAHAWAIIIDAHOILLINOISINDIANAIOWAKANSASKENTUCKYLOUISIANAMAINEMARYLANDMASSACHUSETTSMICHIGANMINNESOTAMISSISSIPPIMISSOURIMONTANANEBRASKANEVADANEW HAMPSHIRENEW JERSEYNEW MEXICONEW YORKNORTH CAROLINANORTH DAKOTAOHIOOKLAHOMAOREGONPENNSYLVANIARHODE ISLANDSOUTH CAROLINASOUTH DAKOTATENNESSEETEXASUTAHVERMONTVIRGINIAWASHINGTONWEST VIRGINIAWISCONSINWYOMINGAMERICAN SAMOAFEDERATED STATES OF MICRONESIAGUAMMARSHALL ISLANDSNORTHERN MARIANA ISLANDSPALAUPUERTO RICOU.S. MINOR OUTLYING ISLANDSARMED FORCES AMERICASARMED FORCESARMED FORCES PACIFICALBERTABRITISH COLUMBIAMANITOBANEW BRUNSWICKNEWFOUNDLANDNOVA SCOTIANORTHWEST TERR.NUNAVUTONTARIOPRINCE EDWARD ISLANDQUEBECSASKATCHEWANYUKON Zip * Zip Suffix Home Phone * Work Phone Mobile Phone Email * Occupation * Hours you are away from home on a typical weekday (e.g., 8:00 a.m. – 3:00 p.m.) * How did you hear about us? * What name would you like to use on formal correspondence, certificates, etc.? (e.g., Sue Jones and Bob Smith, Susan Jones and Robert Smith, The Smith-Jones Family, etc.) Are you interested in becoming a Hero Dogs * Puppy Raiser Puppy Sitter Either Other Household Members List all the members of your household, their relationship to you (spouse, child, etc.), occupation, and the hours that person is away from home on a typical weekday (e.g., 8 a.m. – 4:30 p.m.). Please give ages of children. EXAMPLES: Bob Smith, spouse, auto mechanic, away from 7:00 a.m. – 6:00 p.m. Peter Smith, son, age 9, away from 8:30 a.m. – 3:30 p.m. Judy Smith, daughter, age 3. Person #1 Person #2 Person #3 Person #4 Person #5 Person #6 Is everyone in the household excited and in agreement about raising/caring for a Hero Dog puppy? * Yes No Please tell us why you are interested in becoming a Hero Dogs Puppy Raiser or Sitter: * Is anyone in the household allergic to dogs? * Yes No Is anyone in the household afraid of dogs? * Yes No Do you expect puppy raising/sitting to be a project for a child/children in your household? * Yes No If yes, please describe the responsibilities you envision for the children.