Instructor ApplicationPlease enable JavaScript in your browser to complete this form.Name *FirstLastAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *Provide a brief description of why you would like to be a pet CPR instructor *Please check off your professionVeterinary professional (Vet Tech, Vet Assist or Licensed Veterinarian)Dog TrainerGroomerRescue or Shelter Staff and/or VolunteerPet Sitter/Dog WalkerPolice or Military K9 HandlerOtherIf other, please list professionIn at least 200 words, explain your professional animal/veterinary work experience. *Please provide two references, including their first and last names, email addresses, and phone numbers, who can confirm your professional experience working with animals. *List the best days and times that you would be available for an interview. *Credentialed veterinary technicians are eligible to also teach our advanced class. Check here if you fit that criteria and would like to teach this additional program.PetCPR+ Advanced for Vet Professionals (vets and vet techs only)I understand that if I am hired to be an instructor I will be required to obtain the necessary equipment and supplies in order to teach a class. *I AgreeInstructors are not required to purchase supplies up front. They may wait until they complete the complimentary training before investing in equipment and supplies. Supplies may be purchased through Pet Emergency Education for the cost of $475 or they may obtain the required supplies on their own and provide Pet Emergency Education with proof of ownership.How did you hear about us? *Choose OneFacebookLinkedinIndeedEmailReferral from current instructor (list name below)If referral please list name of person referring youI verify that I have read the instructor program FAQ as well as the policies and Guidelines and agree to abide by all of the rules and requirements stated in it as long as I am an active instructor with Pet Emergency Education. I understand that by filling out this form I am not guaranteed to become an instructor. *I AgreeEmailSubmit 2018-11-13
