Basic Manners Class Registration

Basic Manners Class Registration

Please fill out the form entirely, one for each pet attending.
Name *

First Name Last Name
Phone Number *
(555) 555-5555
Email *
example@example.com
Dog's Name *
Dog's Sex

Male Female
Have you and this dog been to one of our training classes before? *

Yes No
Address *

Street Address

Street Address Line 2

City State

Zip Code
Dog's Date of Birth *

Month Day Year
Approximate Weight *
In Lbs.
Breed *
How old was your dog when he/she was spayed/neutered? *
Type INTACT. if your dog has never been spayed/neutered
Has your dog aggressively bitten? *

Yes, my dog bit me Yes, my dog bit a family member Yes, my dog bit a stranger Yes, my dog bit another family dog Yes, my dog bit a non-family dog No Yes, something else...please explain
What are your dog training goals? *
How did you hear about us? *

Internet Search White Haven Veterinary Hospital Courteous Canines Inc. International Association of Animal Behavior Consultants Pet Professional Guild FearFreePets.com Facebook Instagram From my Vet Word of Mouth/From a Friend Other
If referred by a friend, please tell us who so we can thank them:
Choose both the calendar date and time for the class you wish to attend. *
Please read the below agreement carefully before signing it.
Signature

Clear
Would you like to pay for class now? *

Yes No
If you'd like to pay now, check the box below. If you'd like to pay at class I accept cash, check or credit card. There is a $1.00 discount per class for check/cash payments.
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Basic Manners Class For dogs 5-months old or older
$ 26.00

Total

$ 0.00

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