2. Attachment A- ACO Trainer Applicaiton Form- REQUIRED with Submission.pdf

AGR-ACO-Trainers-FY26

MASSACHUSETTS ANIMAL FUND

ANIMAL CONTROL OFFICER TRAINING INSTITUTE TRAINER

APPLICATION COVER SHEET

Required with Submission

CONTRACTOR INFORMATION:

Date:

Contact Name:

Municipality:

Legal Contractor/Business:* SSI or EIN Tax ID Number: * Address City, Town, Zip Email:

Phone:

Core Competencies Completed: Year Completed or NA *Note: All legal contractor names must match Tax ID numbers associated with the legal name being referenced

PROPOSED COURSE INFORMATION:

Please check ALL modules you are interested in providing instructions for:

1. MAF ACO Core Competencies Trainer

Massachusetts state laws Wildlife Record-keeping & report writing Emergency Preparedness Companion animal identification, behavior, and safe handling Officer Safety and Public Outreach

2. MAF ACO Continuing Education Trainer

Animal cruelty investigations Animal Impounding Officer safety Communications / Public Relations Capture & safe handling Wildlife Emergency preparedness Agricultural animals Rabies Massachusetts state law Compassion fatigue Exotic animals Animal Hoarding Community engagement Fundraising Other:

AGR-ACO-Trainers-FY26

Names and credentials of all instructors: Include a Resume or bio for each along with your application.

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5.

Have you taught /coordinated this course previously? Yes / No If Yes, when?

How is the course completed? In-person or online?

If in-person, could it be modified to be taught online? Y/N If this in-person, do you have a location to hold it? Y/N If yes, where is this facility located?

Maximum number of students you can instruct at one time?

What is the duration of this course?

Is the course offered at no cost to the student? (Y/N) If No, what is the cost per student? ($) List any additional costs associated with this course. ($ and Description)

Provide 3 References:

Name Email Phone robert.monahan Line