Equipment Request

Are you applying for yourself? *

Handler name *

Handler's Title *

Agency *

K9's Name *

K9 Trauma KitNarcan KitRex Specs

Cell Phone *** YOU WILL BE CONTACTED VIA TEXT - DO NOT ENTER AN AGENCY LANDLINE **

Email Address *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Have you applied for similar equipment from a separate non-profit in the last 12 months? *

Additional K9 Information

K9's Breed *

K9's Age *

ObedienceApprehensionTrackingTrailingNarcotics DetectionExplosives DetectionElectronics DetectionCadaver DetectionOther

Are you working with a private sponsor? *

How did you hear about Protecting K9 Heroes?

Is there any additional information you would like to provide?

Please upload all required files

Drag and Drop (or) Choose Files

P.O. Box 422, Glenwood, IL 60425