Thank you for your interest in joining Creature Comfort Pet Therapy! 

Once you have filled out the application, please send the pet records to kclark@ccpettherapy.org to schedule a test date.
Applicants may be asked to undergo a background check in accordance with our facility contracts.

What is the primary email address for matters relating to this animal?

Your information


Required fields are marked with an asterisk (*). One of the fields below is a file upload/attachment, the file size must be less than 10MB.

PET'S INFORMATION
Pet's name *
Pet Type *
Pet Type (Other) *
Pet Breed *
Pet Gender *
Pet Birthday *

A valid date as MM/DD/YYYY (for example: 11/30/2015)

PRIMARY HANDLER INFORMATION
Salutation
First name (primary handler) *
Last name *
Name as you would like it to appear on certificate
Your birthday *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Mobile phone *

For example, 123-456-7890
SMS/text messaging: By providing your mobile number and checking the box below, Creature Comfort Pet Therapy will be allowed to send you SMS (text) messages relating to their volunteer activities. To opt-out, reply STOP to any SMS message OR return to this form and uncheck the box.
Secondary Phone
Street Address *
City *
State (CCPT only visits in NJ) *
Zip *
County (CCPT only visits the below counties) *
County Other
Availability for visiting (Please be specific, Ex: Mon - Thur 10a-4pm and Sat) *
Any interest/skills for additional volunteer opportunities with CCPT?

ADDITIONAL HANDLERS
How many additional people will be certified to handle this animal?
Other handler #1: Salutation
Other handler #1: First name
Other handler #1: Last name
Other handler #1: Mobile phone
Other handler #1: Email
Other handler #1: Birthday

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Other handler #2: Salutation
Other handler #2: First name
Other handler #2: Last name
Other handler #2: Mobile phone
Other handler #2: Email
Other handler #2: Birthday

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Other handler #3: Salutation
Other handler #3: First name
Other handler #3: Last name
Other handler #3: Mobile phone
Other handler #3: Email
Other handler #3: Birthday

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Other handler #4: Salutation
Other handler #4: First name
Other handler #4: Last name
Other handler #4: Mobile phone
Other handler #4: Email
Other handler #4: Birthday

A valid date as MM/DD/YYYY (for example: 11/30/2015)

ADDITIONAL INFORMATION
Check all that apply


Pet is certified with another therapy organization






Other - Which therapy organization?
How did you hear about CCPT? *




What training facility?
What Veterinary Practice?
How did you hear about CCPT? (Other)