National Animal Care & Control Association Course/Training Application Form

Applicants must currently work in animal welfare in an enforcement capacity or with field services duties.


    Applicant Information


    Are you a current NACA Member?
    Is your agency a current NACA Member
    City*
    State*
    Zip*
    Preferred Telephone Number*:
    Alternate Phone:
    Date of Birth*: M/D/Y
    Gender:
    Race:

    Organization Statistics/Information


    Number of Team Members:

    Full Time
    Part Time
     
    Contract
    Volunteers
     

    Annual Intake:

    Dogs
    Cats
    Others

    Annual Calls for Service:

    Cruelty Total
    Dangerous Dog
    Nuisance

    Annual Organization Budget:

    Annual Training Budget:

    Current Programs (Check all that apply):

    Type of Scholarship Requested (Check all that apply):

    Please explain how scholarship funding will support your agency and its training program.


    Are you seeking and would be ok with:

    Would you be unable to attend without a full scholarship?

    Would you be unable to attend without a partial scholarship?
    If yes, what’s the minimum amount?


    Applicant Areas of Expertise


    NACA represents Animal Control and Animal Welfare professionals from all across the country. This includes individuals from a wide variety of organizations with varied clientele, demographics, resources, services provided, etc. We understand these diverse challenges and want all potential applicants to know, individual answers will be weighted based on creativity and passion and not on performance of any individual's organization. Please fill out the essay to the best of your ability (in the language in which you feel most comfortable) and with information you feel comfortable sharing with NACA

    STATEMENT OF ACCURACY FOR STUDENTS


    I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. By signing below my supervisor and I acknowledge the time commitment of the course applied for and commit to attending barring any unforeseen emergencies.

    Scholarship Applicant Name*:

        Date Submitted:

    Supervisor/Director Name*:

        Date Submitted:

    Email Address of Supervisor/Director*:

    By submitting this application you are agreeing to have your email address included in future NACA or ASPCA Animal Control Communications.