Beginner's Class Application

 

Please note: Classes are limited in size, classes fill on a first come first serve basis.

Application and fee must be received BEFORE class starting date to insure placement in class.

You will be contacted ONLY IF CLASS FILLS.
Refunds will only be made if contacted 10 days prior to class. NO REFUNDS AFTER CLASSES START.

 

Type of class (circle one) Beginner’s Class $75 ($80 as of 6/1/2010) / 7 weeks. - Advanced Class $70 ($75 as of 6/1/2010) / 7 weeks.

 

Class Starting Date:__________________________ Time:_____________

 

Name ____________________________________ Email address:_________________________

 

Address_____________________________________________________

 

City and State ________________________________________________ Zip_________

 

Phone (home) _________________________ (work)___________________

 

Breed of dog _________________________ Call name________________

 

Age of dog ___________________________ Sex ____________________ Weight______

 

All dogs 4 months and older attending class must have received a rabies shot.

Is your dog up to date on all other shots? YES  NO   Veterinarian’s Name:______________________

 

BEHAVIORIAL INFORMATION

Do you have children in your home? YES NO

If yes, what are their ages and how well does your dog interact with them?_____________________

______________________________________________________________________________

 

Do you have any other animals in our household? YES NO

If yes, what other animals do you own and how well does your dog interact with the other animals of the household?

______________________________________________________________________________

 

Had you had any difficulty with aggression with your dog? YES NO

If yes, please explain._____________________________________________________________

______________________________________________________________________________

 

Has your dog been exposed to other dogs? YES NO

If yes, was your dog’s response negative or positive?______________________________________

______________________________________________________________________________  
If you have any particular concerns of problems with your dog that you would like your instructor to know about, please list them on the back.
 

MAKE CHECK PAYABLE TO:                 SHAMROCK ACRES TRAINING CENTER

                 MAIL TO:                 LINDA COATES - 621 INDIAN RIDGE RD - LOUISVILLE, KY 40207