In order to apply for an assistance / service dog, please fill out and submit the following form. Applicant Name & EmailName(Required) First Last Email(Required) Type of Dog DesiredType of Dog Desired(Required) Mobility Assistance Dog Autism Dog Companion Dog Diabetic Alert Dog Emotional Support Dog Facility Dog Guide Dog Hearing Alert Dog Medical Alert Dog (other than the types specifically listed) Post Traumatic Stress Disorder (PTSD) Dog Seizure Alert Dog Therapy Dog Δ