Quiet Dog Registration Form

To send in registration form please copy, paste, and fill out entire form in an email and email to info@caninecompanion.us OR print off this page, fill out, and mail to:

Canine Companion by Certified Trainers

11742 N. 825 W.

Huntington,IN46750

CANINE COMPANION

Quiet Dog Registration Form- REGISTRATION FORM

COMPLETE & RETURN THIS PAGE

Date:                     __________________________________________

 

Owner’s Name:     __________________________________________

Address:                __________________________________________

___________________________________________

Phone (Home):  _______________________  (Work________________

Phone (Cell):         _______________________

E-mail address:    ________________________________

Dog’s name:         ____________________ D.O.B.       _________________

Breed/s:                 ____________________ Gender:  ____________

Regular Vet:                    ____________________ Phone #: ____________

Date of vaccinations:     ____________________________________

(if alternative measures have been taken, please explain)

What situations make your dog bark?

  1. ______________________________________________________
  2. ______________________________________________________
  3. ______________________________________________________

Is there anything else you would like us to know about your dog?

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Where did you hear about our training program?

________________________________________________________________________