Service Dog Class Registration

Your Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Dog's Name*
Enter the class date you'd like to register for*
Additional Information

If this is your first time registering THIS dog, complete all Additional Information below. If you have registered this dog previously, you may SKIP this section and scroll down to the Acknowledgement.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Dog Size
Dog Breed
Age
Sex

MaleFemale
Spayed/Neutered?

YesNo
Where did you get your dog?

Where does your dog stay/sleep...

	Yard	House	Garage	Crate	Kennel
During the Day
At Night

If Yes above, how many other pets in your household?

	Total Pets	# of Dogs	# of Cats	# Other Pets
Pets

Have you owned a dog(s) before?

YesNo
What tasks will you need this dog to perform?
Date & location that you took & passed CGC
Previous Training Experience, Titles, Certificates
Acknowledgement
Click HERE to review the Class Terms & Conditions.
Acknowledgement*

I agree to the Class Terms & Conditions.
If you click the Submit Your Registration button and nothing happens, you may have missed some required information. Missing information is marked in red. Please scroll to the red areas to fix this. Thanks.
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Service Dog Class/6weeks$129.00

Total $0.00
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Additional Information