READ Workshop Registration Form

Please complete the application form below as completely and accurately as you can. If you are already a member of a nationally registered therapy organization, please email us a copy of your membership card. mailto:Melissa@CAREingPaws.org.

NOTE - Each field below that contains an asterisk (*) is required.

R.E.A.D. Workshop registration FORM

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Primary Phone Number *

Email *

Occupation *

Which R.E.A.D. Training Session would you like to sign up for? *

How did you hear about CAREing Paws? *

What is your animal's name? *

Breed? *

Describe any training and/or titles you and your dog have accomplished or are currently pursuing (e.g., CGC, agility, etc.). *

Upload Certificate of training course completion. *

Max file size: 20MB

Participation in our program requires registration with one of the nationally recognized therapy dog organizations. Are you currently a nationally registered therapy team? *

Yes Currently Pursuing No

If yes or currently pursuing, which national therapy organization? *

Alliance of Therapy Dogs Pet Partners Therapy Dogs International N/A

What is your ATD Member number or Pet Partner ID number? *

When is your renewal date or expiration date? *

If you are an ATD team, what is your dog's number? *

Who was your tester/observer or evaluator? *

Please tell us why you feel you and your animal make a great therapy team. *

Printed Name (Typing in your name here acts as your signature) *

Date *

Submit

Note: If you are already a registered therapy team with your animal, please email a copy of your membership card to mailto:Melissa@CAREingPaws.org.