Upper Michigan Dog
Therapy Partnership
Attention:
Recreational Therapy
580 W. College Ave.
Marquette, MI 49855
Volunteer
form - Upper Michigan Dog Therapy Partnership
| Print,
fill out and send the form to:
Upper Michigan Dog
Therapy Partnership |
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Your Name |
_______________________________________________ |
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Your Address |
_______________________________________________ |
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Your Phone Number |
_______________________________________________ |
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Dogs Name and age |
_______________________________________________ |
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Your Dogs Breed |
_______________________________________________ |
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How Did You Hear About the UMDTP ? |
_______________________________________________ |
| _______________________________________________ | |
| _______________________________________________ | |
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Why are you interested in the UMDTP? |
_______________________________________________ |
| _______________________________________________ | |
| _______________________________________________ | |
Please check your areas of interest? (you can check more than one): |
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| ________ | Obtaining Pet Partners Certification and volunteering with the UMDTP. |
| ________ | Obtaining Pet Partners Certification and visiting other health care facilities on my own. |
| ________ | Volunteering with the UMDTP to do administrative and educational projects. |
Please check the frequency of involvement you would be willing to commit to if you volunteered with the UMDTP:
______2x/week ______1x/week ______1x/month
If you volunteered with the UMDTP, please check the days and times of day you would most likely be available.
__Mon __Tues __Wed __Thurs __Fri __Sat __Sun
___ 9 am - 11 am ; ___1 pm - 3 pm ; ___6 pm - 8 pm
Other comments ________________________________________________
