Career Change Application Career Change Application Please enable JavaScript in your browser to complete this form. - Step 1 of 4Name *FirstLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *Your Age *Under 2020-3535-5050-6060+NextEmployer *Job Title *Please describe your typical work day (i.e., time you get up, go to work, get home, etc.): *Please enter information on all other members of the household. (Name, Relationship to Applicant, Age, Disability Status) *Name, Relationship to Applicant, Age, Disability StatusType of Home: *ApartmentCondoMobile HomeTwin HomeSingle Family HomeOtherHow many levels does your home have? *1234Approximate square footage of home: *Where is your home located? *CitySuburbsRuralDo you have a securely fenced yard? *YesNoApproximate square footage of yard: *Where exactly would the dog sleep? *How many hours a day on average will the dog be left alone? *0-23-56-88+When left alone, where will the dog be? *InsideOutsideDo you own or rent your home? *OwnRentDo you have the landlord's permission to have a dog in the home? *YesNoPlease provide landlord's name and phone: *NextDo you have any other animals in your home? *YesNoPlease describe all animals currently in your home: *Breed/Type, Age, Sex, Spayed/Neutered?, Temperament, How Long in Your FamilyName of Current Veterinarian (or veterinarian you intend to use if you do not currently have one): *Veterinarian Address Information *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeVeterinarian Phone *Do you have previous experience with dogs? *YesNoPlease explain your dog experience: *NextWhy do you want a career change dog? *Is there anything else you would like us to know about you?Reference Name *FirstLastPlease provide a reference who does not reside with you.Reference Phone *Second Reference Name *FirstLastPlease provide a second reference who does not reside with you.Second Reference Phone *Required Acknowledgments *I understand and agree that a career change dog cannot be used or listed as a working service dog under any circumstances.I understand that submitting an application does not guarantee an adoption.I understand that only complete applications will be considered.CommentSubmit