Puppy I Registration

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 Puppy I Registration Form- REGISTRATION FORM

COMPLETE & RETURN THIS PAGE

Date of class:         __________________________________________

Location of class:   __________________________________________

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 unwanted problem behaviors is your puppy exhibiting?

  1. ______________________________________________________
  2. ______________________________________________________
  3. ______________________________________________________

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

________________________________________________________________________

_______________________________________________________________________

________________________________________________________________________

Where did you hear about our training program?

________________________________________________________________________