Training Class Admission Information Form

K9 Kampus Training Class Information Form
Owners Name
Cell
Address
Text?

Yes Np
Other Phone#
Email
example@example.com
Vet Clinic
Dog’s Name
Breed
Age
Sex

Male Female
Neutered / Spayed

Yes No
Have you ever trained a dog before?

Yes No
Have you ever done Agility before?

Yes No
If yes, please explain
What training facility was used?
Has your dog ever exhibited aggression: toward people?

Yes No
If yes, please explain
Has your dog ever exhibited aggression towards other dogs?

Yes No
Please explain
Do you or have you socialized your dog? (check all that apply)

Dog Park Daycare Pet Store Other
Facility and location your dog attended daycare at
What are your goals for this class?
What issues do you have with your dog that you hope to remedy in this class?
I’m interested in

Attending classes Private Sessions with my dog and the trainer
I don’t have time to attend classes I prefer to drop my dog off for

Day Training Program Board Training Program
My Obedience interests are: (check all that apply)

Basic Obedience Novice Obedience (continuation of Basic Obedience) Intermediate Obedience
My other interests are: (check all that apply)

Tricks Class Competitive Obedience Rally (Obedience with sign) Canine Good Citizen Certification Therapy Certification Conformation (handling for the Breed Ring ) Agility Session A Agility Session B Agility Session C Agility Novice Course Work Other
Signature *

Clear
Signature
Date

Month Day Year
Date
Should be Empty: