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2025 Application
2025 Application
Jim
2025-01-13T19:36:25-06:00
Handler's Name
(Required)
First
Last
Handlers Department
(Required)
Handler's Address
(Required)
Street Address
City
Alabama
Alaska
American Samoa
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Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
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Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Handler's Phone
(Required)
Handler's Email
(Required)
K-9 Name
(Required)
Breed
(Required)
Photo(s) for website
(Required)
Drop files here or
Select files
Max. file size: 8 MB.
Bio for website
(Required)
Function (select all that apply)
(Required)
Cadaver
Explosive Detection
Narcotics Detection
Patrol
Search and Rescue
Date of Birth (best guess if unknown)
(Required)
MM slash DD slash YYYY
Department Served
(Required)
Years in Active Service
(Required)
Reason for retirement:
(Required)
Pertinent medical history and care required
Current Medications (Name, Dose, Frequency)
For what care is the current funding being requested for? (Check all that apply)
Annual Exam
Refill of Medications
Injury
Illness
Annual Exam Due date
MM slash DD slash YYYY
Medications Needed
How did you hear about MARK-9?
(Required)
MARK-9 Certifying Statement
Max. file size: 8 MB.
https://www.mark-9.org/wp-content/uploads/2017/10/MARK-9_Certifying_Statement_v6_2017.pdf If you wish to submit your application without uploading now, you can. The MARK-9 Certifying Statement can be sent via fax or email once completed.
Consent
(Required)
I agree to receive emails from MARK-9.
I understand that if I unsubscribe from MARK-9 emails, I will miss out on important program updates and risk being dropped from the program. We will not spam you. Email is the only way we have to communicate with you.
Renewal
(Required)
I understand I will need to renew my K9s status every May 30th.
You will receive an email in early May asking for an update on your K9. You must provide this update to remain a MARK-9 recipient.
Status
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