Our Volunteer Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please note that Canine Friends Pet Therapy dogs do not qualify as official Working Dogs (like guide dogs) however our assessment/scarf/badge gives hospitals and rest homes assurances that our dogs are well suited to those environments. We do not support a Canine Friend Pet Therapy dog being at a work place. Our dog teams usually only do up to an hour visiting per day at rest homes, hospitals and hospices.

Email *

First Name : *

Last Name: *

Contact Phone Number *

Street Address (eg 123 North Street) *

Suburb only please (eg Miramar)

City AND Postcode please (eg Wellington 6022) *

Occupation *

When are you able to visit? *

Note: There is an expectation that you will do a minimum of 2 hours visiting over a month.

Any day of the week

Any week days

Any weekend days

Only on a specific day

Please indicate what type of facility you would like to visit. (Note: You can pick more than one) *

Rest Home

Hospital

Hospice

Dementia Unit

Rehabilitation Home

Required

List any previous visiting experience you may have

Dog's name *

Dog's Age *

Note: Dog's under 12 months of age will not be accepted

Dog's breed *

Note: We do not select breeds that are listed as "banned" under the NZ Dog Control Act 1996 such as American Pit Bull terrier type dogs, Dogo Argentino, Brazilian Fila and the Japanese Tosa breeds.

Dog Weight
Note: We collect this information so that our sponsor can provide you with a free sample of their product. *

Menacing or Dangerous Dog

I confirm that I do not have a dog that is listed as banned under the NZ Dog Control Act 1996

I confirm that my dog has never been/or currently is classified as Dangerous

I confirm that my dog has never been/or currently is classifed as Menancing

Other:

Dog's sex

Male

Male - Neutered

Female

Female - Spayed

Clear selection

Has your dog received formal training? *

This is training provided by a professional trainer or through an Obedience Club

Yes

List the formal training

Are your dog's vaccinations up to date?

Note: You will have to show an up to date vaccination certificate for your assessment.

Yes

Clear selection

How did you find out about Canine Friends Pet Therapy?

Social Media

From a friend or acquaintance

Through an online search

Newspaper, radio, TV or a magazine

My vet

At an event

Other:

Clear selection

How would you like to receive our quarterly newsletter?

By email

By post

Clear selection

Can you tell us briefly why you would like to be a member of Canine Friends?

Finally - please confirm that you understand and will abide by our Terms and Conditions by ticking all the boxes by below *

I have read the Code of Ethics and the Ground Rules for Members.

I will pay the joining fee and the annual membership fee (which are on the website)

I will undertake Police Vetting if required

I will keep my dog's vaccinations up to date while visiting

Required

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms