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K94Heroes application requires the following:

Today’s Date ___________________________________

Copy of your DD – 214 _________

An Interview in person or by phone _________

Name _____________________________________________________

Date of Birth ______________________

Your Email ________________________________________

Phone Number ___________________________________________

Your Address ______________________________________________________________________________________________________________________________________________________

What type of dwelling do you live in? ____________________________________________

Bottom of Form

Do you rent? ____________

If you rent, does your landlord allow animals? _______________

Can you please provide the name and age of all people living with you? ______________________________________________________________________________________________________________________________________________________

Branch of Service? _______________________________________

Current Military Status ______________________________________________

Conflict Serve In ________________________________________________

If you are NOT a veteran:

Name of veteran relative (First and Last) ________________________________________

Your Relationship to the veteran? ________________________________

Medical Diagnosis ______________________________________________________________________________________________________________________________________________________

Please tell us why a companion dog will help you. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Do you have any pets now? ____________________________________________

Are you able to care for a dog? (Walking, Feeding, Playing, Veterinarian Care, Etc) _______

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