AAEC Enrollment Application

Enrollment Application
New client or existing client?

New clientExisting client
Which consult are you requesting? Please mark one.

FREE 15 min phone consultation?Initial evaluation and 1st Lesson? ($199/90 min session)
Appointments are not finalized until you receive confirmation.
Client Info
Name*

First NameLast Name
Best number to reach you*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Select which programs you are interested in. Initial Evaluation required prior to enrollment in any program:*

Behavior ConsultationDay School Enrollment *Limited availability for this accelerated programPrivate School- In Home/ Real World/ Campus/ HybridGroup Class Memberships- In Person/VirtualHomeschooling- Trainer Supported Virtual/Remote LearningS.M.A.R.T. Pup Tutoring- Private Day Train Accelerator (just pup & trainer)Self Paced Self Study- Videos, Materials, and Coursework OnlyPuppy KindergartenTherapy or Service ProgramsEnrichment Daycare or BoardingCanine Confidence Course MembershipsStay & Learn AcceleratorOther Services
Dog's Info
Name*
Breed and Color
Gender

MaleFemale
Weight in lbs
Age
Is your dog spayed /neutered?*

NeuteredSpayedNo
Is the dog up to date on ALL his/her vaccinations (Rabies, Distemper, Parvo, Bordatella); flea, tick, and heartworm prevetion? Please have your vet forward your pet's medical records to animalacademyec@gmail.com*

YesNo
Is dog your dog crate trained?

YesNo
Does your dog show any signs of anxiety?

YesNo
If yes, please give brief description of the anxiety.*
Is dog in good and healthy condition?

YesNo
Please list any medications, allergies, illnesses, special conditions or medical concerns involving your pup. If none type N/A*
My dog gets along well with:

Most other dogsSome other dogsNo other dogs / I don’t knowCatsStrangersKids
Has your dog ever at growled, snapped, or bitten another animal or human?

Yes, HumanYes, another dogYes, OtherNo
If Yes, did your dog draw blood?

YesNo
Why did you get a dog? Describe your ideal life with your dog.
What are your top 3 goals with your dog?
Any special instructions or things you would like us to know?
How did you hear about us?*
If referred, specifically by who? We like to thank our friends!*
If enrolled, how will you be paying your tuition? We accept all major credit cards, Paypal, Venmo, check and cash. All electronic payments have an additional convenience fee. Tuition payment is required to hold your spot.

CashCheckPaypalVenmoMajor Credit Card
Upon receipt of your application, you will be contacted by a member of our team to find a program that best suits your needs. If you have more questions please contact us at (850) 739-2878. We are always happy to help.
Should be Empty:

Enrollment Application

Client Info

Dog's Info