K9 Handler Application: 2302-FL-SART Application Form (2302-FL-SART) "*" indicates required fields Agency InfoAgency*Please spell out fully Agency Type* Military Federal State Local (City/County) Agency Address Line 1 Agency Address Line 2 Agency City Agency StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAgency Zip Student InfoI am an active uniformed K9 Handler*Yes - I am active uniformed handler based in FloridaYes - I am active uniformed handler that frequently works in FloridaYes - I am a Federal uniformed handler with the potential for work assignments in Florida.None of these apply to meI have previously attended the following Florida SART Sponsored K9 MEDIC Classes: April 2021 - Camp Blanding February 2020 - Camp Blanding December 2017 - Tampa Student Name for Certificate* First Last Unit* Student's Work Email* Enter Email Confirm Email Student's Phone*Human Medical Experience* None First Aid First Responder EMT AEMT Paramedic Critical Care Paramedic Nurse Physician TEMS/TCCC/TECC Veterinary Medical Experience* None Canine First Aid Canine First Responder / Paramedic Veterinary Assistant Veterinary Tech Veterinarian Veterinary Specialist K9 TEMS / K9 TCCC / K9 TECC K9 InfoK9 Breed(s)* Mission Types* LEO Military Wilderness SAR Urban SAR Disaster SAR Prehospital EMS Checkpoints Airports Explosives Detection Narcotics Detection Human Remains Detection Agricultural Detection Electronics Detection Other Demo Dog Candidate?If you would like to be considered for providing a Demo Dog, please explain what would would make your dog a good candidate. And list 2 things that the Demo Dog Requirements document said to bring with you to class.Supervisor's InfoThis information is used only to ensure that the K9 Handler above is authorized to attend the training. If the supervisor wishes to attend training, they would need to apply seperately.Name of Student's Supervisor* First Last Supervisor's Phone*Supervisors' Email* Enter Email Confirm Email I understand that...*- I will be required to follow any then-current COVID-19 requirements Yes, I agree EmailThis field is for validation purposes and should be left unchanged.
