Volunteer Application for Bishop’s Mission CISM K9 Handler Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Date of Birth * MM DD YYYY Section 2: Background and Experience Are you a current or former emergency responder or military veteran? * Yes No Have you participated in Critical Incident Stress Management (CISM) or Peer Support training? * Yes No Do you have experience working with therapy animals in crisis settings? * Yes No Do you have any other relevant training or experience? YES NO Section 3: K9 Information Dog's Name Dog's Breed Dog's Age Is your dog therapy-certified? * Yes No Is your dog up to date on vaccinations or titer tests? * Yes No Proof of vaccination or titers will be required during onboarding. Has your dog participated in any crisis intervention or debrief settings? * Yes No Does your dog have any known allergies or behavioral issues? * Yes No Section 4: Availability and Transportation Are you available for call-outs with a few days’ notice? * Yes No Do you have reliable transportation? * Yes No Are you willing to travel outside your immediate area? * Yes No Section 5: References Please provide two references who can speak to your experience and suitability for this role: * Yes No Name of First Reference * First Name Last Name Email of First Reference * Relationship * Name of Second Reference First Name Last Name Email of Second Reference * Relationship * Section 6: Additional Information Why do you want to volunteer with Bishop’s Mission? Is there anything else you would like us to know? Section 7: Acknowledgment By signing below, I certify that all information provided is accurate and complete to the best of my knowledge. I understand that submitting this application does not guarantee acceptance as a volunteer. I agree to abide by Bishop’s Mission policies and procedures if selected. Date MM DD YYYY Thank you for your application. A member of our team will contact you to discuss the next steps. For questions or concerns, please email [Insert Contact Email] or call [Insert Contact Phone Number]. Thank you! Download Critical Incident Stress Management (CISM) Volunteer Requirements, Policies, and Procedures
