Emotional Support Animal Handler Agreement Form Student Handler Information: This student has been approved by Kalamazoo College Disability Services for the housing accommodation of an Emotional Support animal to live with them in on-campus college housing. Student Name * Required First Last Student ID * RequiredCell Phone Number * RequiredK Email * Required Housing Assignment * RequiredType of Animal * RequiredName of Animal * RequiredPhysical Description of the Animal * RequiredYour signature on this agreement indicates that you understand the following: The Emotional Support Animal (ESA) must be contained within the Student Handler room at all times, except as required for transportation off-campus or to eliminate waste. While outside the Owner’s housing, the ESA must be in an animal carrier or controlled by leash or harness unless the Student Handler’s disability prevents its use or would interfere with the animal’s safe and effective performance of its work or tasks. The Student Handler must comply with the College policies regarding noise, safety, disruption, and cleanliness. The Student Handler must ensure that the ESA does not create persistent odor, noise, or disturbance. ESA’s must be housebroken. The Student Handler must remove, or arrange for the removal of, the animal’s waste and dispose of all waste at least once a day. Waste must be disposed in an outside trash receptacle, never indoors. When leaving the room, the ESA shall be restrained with a leash or be transported in a cage or appropriate container unless the Student Handler’s disability prevents its use or would interfere with the animal’s safe and effective performance of its work or tasks. It is highly recommended that the animal wear an identification tag for its safety in case the animal becomes loose or lost. When the Student Handler leaves the room without the animal, the animal must be securely caged if possible. The ESA may not be left unattended for any unreasonable length of time, which will depend in part of the species of the animal. The Student Handler must take the animal with them when leaving campus for a prolonged period of time, and may not leave the Approved Animal in the care of any other resident overnight. Approved Animals may not be left overnight in housing without notification to and approval by Residential Life. The ESA must be current with appropriate immunizations and vaccinations and, when applicable, wear a rabies vaccination tag. Current immunizations and vaccinations records must be submitted to the Associate Dean of Students who oversees Disability Services with this agreement and updates as necessary. If the ESA is a dog, the student must comply with Kalamazoo County and/or City of Kalamazoo dog control and licensing laws, and with all responsibilities regarding animal rights and all other owner responsibilities. As with anyone living in campus housing, the College may bill the student for damage beyond normal wear and tear or for necessary cleaning above and beyond the standard cleaning of the room. Handlers are responsible for providing their own cleaning supplies. If fleas, ticks, or other pests are detected through routine inspection, the student will be responsible for the expense of pest treatment beyond standard pest management used in College housing. The College reserves the right to disallow an ESA in the event of flea, tick or pest infestation. The Student Handler must inform the Associate Dean of Students who oversees Disability Services within 10 days when the ESA is no longer living with the Student Handler. The Student Handler must inform the Associate Dean of Students if the Student Handler is making any room or roommate changes, at which time the a new ESA agreement must be completed. The following are some, but not all circumstances which will prompt the College to withdraw its consent for the ESA to live in College housing: The animal is found to be mistreated or neglected by the Student Handler The animal poses a direct threat to the health or safety of others The Student Handler does not comply with the above responsibilities and/or the conditions as stated in the accommodation letter The animal’s presence results in a fundamental alteration of the college’s program or operations The animal or its presence creates an unmanageable disturbance or interference. Should an animal need to be removed from the College’s property, the Student Handler assumes full financial responsibility for housing or boarding the animal until further arrangements can be made. The permission you have been granted to house an animal extends to this specific ESA only. If you intend to switch ESA’s (i.e. from a cat to a dog, or from one dog to another dog), you must notify the Associate Dean of Students who must authorize the change. Further documentation may be requested at this time as to the necessity of the change and the fundamental impact the new animal will have on the disability of the student. You may be asked to update this agreement if your housing arrangements change or if your approved ESA Changes. Student Handler Signature * RequiredAlternate CaregiverWhile an Alternate Caregiver is not required, the Student Handler may find it to be helpful to have a designated person in case of emergency. If an Alternate Caregiver is designated, in the event the Student Handler is unavailable due to an emergency, the Alternate Caregiver is responsible for fulfilling all obligations of the Student Handler set forth within this document for the entire duration of time that the Student Handler is unavailable. Kalamazoo College is not responsible in the case of an emergency.Alternate Caregiver Name * RequiredAlternate Caregiver Off-Campus Address * RequiredAlternate Caregiver Phone * RequiredAlternate Caregiver Email * Required Alternate Caregiver Signature * RequiredIn an emergency when the Student Handler is unavailable, Kalamazoo College will attempt to contact the Alternate Caregiver. Δ Printable version of the Emotional Support Animal Handler Agreement form [PDF, 217KB]