Name of Individual
Title
Employer
Training Facility Address
Mailing Address
City
State/Province
Country
Zip/Postal Code
Telephone
Fax
Email Address
FEE: There is no fee to become a NESDCA Trainer or NESDCA Training Facility. There may however be expenses associated with travel in the event travel is required by NESDCA to evaluate a facility to be a NESDCA Facility.
Please indicate type(s) membership you currently hold:
Regular Member
Handler
Other (Please indicate below)
1. QUALIFICATIONS OF APPLICANT
a. Provide some background of your general knowledge in Training dog teams.
b. List schools, seminars, workshops, and lectures you've attended to obtain your training knowledge and continued education in the dog training field.
c. Are you willing to abide by, support, and promote NESDCA, our By-Laws and mission of Entomology Scent Detection?
YES
NO
d. Please describe in detail the number of dogs you have trained and in what areas. ie: 5 Law Enforcement drug dogs, 2 Search & Rescue live find, 6 termite dogs, etc..
2. REPRESENTATION
Indicate below the name of the business or company you would be representing and include
written authorization from that entity authorizing you to be their
representative:
3. TRAINING FACILITY
a. Provide a contact name and number at the training facility if different than above.
b. Please provide information about your training facility to include the requirements located in the NESDCA By-Laws
4. ADDITIONAL COMMENTS
NOTE: You must provide NESDCA with a certificate of insurance for liability and workers compensation for a minimum of one (1) million (U.S. Dollars) coverage of each.
If granted NESDCA Trainer and / or Training Facility status, I agree to abide by the RULES and BY-LAWS and agree to notify the Secretary of the NESDCA of a change in status, including change of employment, organization represented, location or funding source.
I attest that all of the information on this
application is true and accurate.
Type your FULL NAME
Today's Date