East Bay Pet Sitters Association
www.ebpsa.org

Thank you for your interest in the East Bay Pet Sitters Association (EBPSA). Membership is open to owner(s) of local, owner operated, non-franchised pet care businesses. Applicants must be referred for membership by a current member of EBPSA. If you do not know a specific member at this time, please do not hesitate to introduce yourself by contacting a member listed on our website.

Prior to filling out the EBPSA application, please read and review the Membership Agreement and Code of Conduct. Your online application submission is in lieu of your written signature that you agree the information is accurate and correct, and you agree to the terms of the Membership Agreement and Code of Conduct. Your application will be automatically sent to the Membership Coordinator, who should be contacting you in a few days to assist you with the next step in the application process.

EBPSA MEMBERSHIP APPLICATION

Fields marked with * are required.

REFERRING MEMBER'S NAME AND BUSINESS NAME *
A value is required.
APPLICANT'S BUSINESS NAME *
A value is required.
OWNER(S) FIRST AND LAST NAME *
A value is required.
MAILING ADDRESS *
A value is required.
CITY & ZIP CODE *
A value is required.
BUSINESS PHONE *
A value is required.
E-MAIL ADDRESS *
A value is required. Invalid format.
WEBSITE

CITY WHERE YOU RESIDE *
A value is required.

DO YOU USE INDEPENDENT CONTRACTORS? *	YES    How many?
	No

Please make a selection. If yes, please include how many contractors you use.

DO YOU HAVE EMPLOYEES? *	YES    How many?
	No

Please make a selection. If yes, please include how many employees you have.

HOW LONG HAVE YOU BEEN IN BUSINESS? *     Just Started 1-2 Yrs 3-5 Yrs 5+ Yrs Please select an item.

HOW LONG HAVE YOU KNOWN THE REFERRING MEMBER?*
A value is required.

HOW DO YOU KNOW THE REFERRING MEMBER?*
A value is required.

DO YOU WALK DOGS ON TRAIL ON OR OFF LEASH?*	YES
	NO

Please make a selection. If yes, please tell which us which parks you use in the text box below.

IF YOU OFFER TRAIL WALKS (ON OR OFF LEASH), WHICH PARKS DO YOU USE?


IF YOU OFFER TRAINING OR GROOMING SERVICES, PLEASE DESCRIBE YOUR SPECIAL TRAINING, CERTIFICATIONS, ETC.


WHY DO YOU WISH TO JOIN EBPSA? * (500 CHARACTER COUNT, INCLUDING SPACES)
A value is required.
TELL US A LITTLE BIT ABOUT YOURSELF, AND WHY YOU CHOSE THE PET INDUSTRY.* (500 CHARACTER COUNT, INCLUDING SPACES)
A value is required.

FOR THE WEBSITE WE WILL NEED THE FOLLOWING INFORMATION:

1. A BRIEF TEXT DESCRIPTION OF YOUR SERVICES. THIS WILL BE PART OF YOUR BUSINESS PROFILE ON THE WEBSITE.* (700 CHARACTER COUNT, INCLUDING SPACES)
A value is required.

2. SERVICES AND SERVICE AREAS*
A. PLEASE CHECK ALL SERVICES APPLICABLE:
(NOTE: IF YOU OFFER BOARDING, TRAINING, AND/OR OVERNIGHTS, YOU MAY SELECT SERVICE AREAS IN SECTION B BELOW FOR THOSE SERVICES ONLY.)

Neighborhood Walks	Cats
Drop-In Visits	Birds
Trail or Off-leash Walks	Exotic Pets
Day Care	Pet Taxi
Grooming

Please make a selection.
PLEASE SELECT YOUR SERVICE AREAS FOR THE ABOVE SERVICES ONLY:

Alameda Albany, El Cerrito, Kensington Berkeley Berkeley North/Hills Castro Valley Concord, Pleasant Hill, Martinez, Benecia Dublin, Pleasanton, Livermore Emeryville Fremont, Union City, Newark, Sunol Hayward Hercules, Pinole, San Pablo, El Sobrante, Rodeo, Crockett Lafayette, Orinda, Moraga, Alamo, Walnut Creek Oakland Downtown

Oakland East Oakland Hills / Mills Oakland Lake Merritt / Grand Oakland Montclair Oakland Rockridge / Claremont Oakland North / Temescal Oakland West Piedmont Pittsburg, Antioch, Oakley, Brentwood Richmond San Leandro, San Lorenzo San Ramon, Danville

Please make a selection.
B. IF YOU ARE OFFERING BOARDING, TRAINING, AND/OR OVERNIGHTS, PLEASE FILL OUT BELOW:

Boarding

Training

Overnights

None of the above

Please make a selection.
PLEASE SELECT YOUR SERVICE AREAS FOR BOARDING, TRAINING AND/OR OVERNIGHTS:

Alameda Albany, El Cerrito, Kensington Berkeley Berkeley North/Hills Castro Valley Concord, Pleasant Hill, Martinez, Benecia Dublin, Pleasanton, Livermore Emeryville Fremont, Union City, Newark, Sunol Hayward Hercules, Pinole, San Pablo, El Sobrante, Rodeo, Crockett Lafayette, Orinda, Moraga, Alamo, Walnut Creek Oakland Downtown

Oakland East Oakland Hills / Mills Oakland Lake Merritt / Grand Oakland Montclair Oakland Rockridge / Claremont Oakland North / Temescal Oakland West Piedmont Pittsburg, Antioch, Oakley, Brentwood Richmond San Leandro, San Lorenzo San Ramon, Danville All of the above

Please make a selection.
* I have read and understand the requirements for membership within the EBPSA Membership Agreement and have read and will abide by the EBPSA Code of Conduct. I agree to uphold the mission statement* of EBPSA and that failure to meet membership Requirements and Code of Conduct can result in loss of membership.
Please make a selection.

* I have contacted the Membership Coordinator prior to submitting this application. Please make a selection.

Mission Statement: To promote the welfare of all animals, and to raise the standards of the pet sitting industry through example, education and cooperation.

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