Professional Pet Sitters Association Of Wisconsin
New Member or Listing Application (PRINT version)

Applying for:   $40 Premier Full Membership   

Business Information
Business Name:      Previously: 
Date business established:        
You are available to clients:  
 Full  Time   Part Time
Number of Other Employees:    
FT Sitters:      PT Sitters:      Other Staff:    
Accepting New Clients:
   Yes     Yes, Dog Walking Only    No

Hours Of Operation:  All(& Overnights) No Overnights    Weekends Only  Weekdays Only  

Most Common Length Visit:  Minutes   Rate: $      Rates aren't set yet or are estimates

Other Rates:

Business Contact Information - Public, may be posted for all
Phone:   Cell Phone:    Other Phone:    

Email:      Fax:

Address:  City:   Zip:

 Business Contact Information - Private, for sitter referrals only
Owner/Contact First Name:              Last:       
Owner (Secondary) First Name:       Last:    

Home Address:  City:  Zip:

Home Phone:   Cell Phone:    Emergency:
Personal Email:    Yahoo ID:

Dog Walking Injections Horse Care Horse Training/Riding House Cleaning
Cats Only Sub Q Fluids Farm Animals Obedience Training Lawn & Garden
Vacation Care Health Care/Pills Reptiles/Snakes Full Yard Scooping
Board Sm Pets In Home Boarding, Licensed up to Dogs, in county/township

Pet Sitter Liability Insurance

 PSA   All Sitters Insured   Special coverage, property of others   Grooming   Daycare

Carolinas  Sole Proprietor   Standard   Bonding   Grooming   Daycare
Other                   Other Bonding 

First Aid:   Red Cross Pet    Red Cross Human  Red Cross Pet FA Instructor   Other 

Pet Sitting:   NAPPS    PSI Level I  PSI Level II   Other 

Dog Training:
Pet Behaviorist: Grooming:

Vet Tech:

Other Certifications:

Other Training, Skills, & Education

Others (please include webpage address if available):

Areas of Operation

Description of Region Covered:

Example:  Kettle Moraine, Lake Country.  Within 15Miles of Wales, Wisconsin
HTML Link to Map (format 'http://www...'): 

Main Zip Codes (please separate each with a comma!):

Limited Zip Codes (please separate each with a comma!):

Main Cities (Please separate each with a comma.  ):

Limited Cities (Please separate each with a comma.  ):

Location of your logo or instructions on how you are sending it.

Information to list with listing:

Additional Notes:

Please note that ALL fields should be completed.  If you don't have a business name, rates, or other information at this time just indicate that in notes fields and fill out what you can.

Please PRINT this application, and send it with your 1st year membership payment of $40 to our treasurer at:

S31W37515 School Section Lake Road
Dousman, WI 53118

After your membership is processed, you will be sent a username & password that can be used to login and setup/manage your listing if you wish to have one.  Please note, processing can take a few weeks (we don't go to the bank often!).  You can contact ppawpetwicom  for updates.

Visitor Number