Application for Training I am registering for: Puppy-K - Student Profile Required Beginner - Student Profile Required Intermediate Advanced Rally Competition Novice Competition Open Competition Utility Owner Street City State ZIp Code Email Best Phone Number Dog's Name Breed/Mix Dog's Age Sex Male Female Spayed/Neutered Yes No Rabies Vaccination Information I am a new member who is NOT enrolled in Puppy-K. Please fill in your dog's vaccine information below. I am enrolling in Puppy K (rabies certification not required) I have previously taken classes with PDTC AND my dog's rabies information is current and on file with PDTC. Date Rabies Vaccination was administered Date Rabies Vaccination expires Veterinarian Name Veterinarian Phone Number Signature I have read and agree to MY AGREEMENT WITH PDTC . (Keep for your information) Your Application is not complete, and your class slot is not guaranteed, until the Training Coordinator receives both your Application and the correct payment. You will receive an email confirmation of your registration. Signature Date Student Profile Dog was acquired from: Breeder Kennel Rescue Shelter Pet Store Other How many adults reside in your household? How many children reside in your household (include their ages)? Have you previously owned a dog? yes no Have you ever attended an obedience class? yes no If yes, describe the class? What commands does your dog currently obey? On a typical day, please indicate the percentage of time your dog is inside/outside: On a typical day, what percentage of time is your dog alone? Do you currently crate your dog? yes no Do you have a fenced yard? yes no What is your primary method of exercising your dog? What words best describe your dog? Click on each word that is applicable. Shy Fearful Bites Aggressive with people Aggressive with dogs Growls Pushy Jumps Destructive Noisy Calm Obedient Protective Excessive energy Excessive barking Other Submit
