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Give Us Paws Training Registration Form
Please fill this form to let us know you are a person suffering from a disability who is interested in paid service dog training.
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* Indicates required question
Email
*
Your email
Owner's Name
*
Your answer
Address
*
Your answer
Phone
*
Your answer
Dog's Name
*
Your answer
Dog's Sex
*
Male
Female
Spayed or Neutered?
*
Yes
No
Age
*
Your answer
Breed
*
Your answer
Current on Vaccinations and Parasite Protection?
*
Yes
No
Where Obtained
*
Your answer
Who is your dog's veterinarian?
*
Your answer
Other Pets in Household
*
Species, Breed, Age
Your answer
Other Adults in House
*
Your answer
Children in House
*
Name, Age
Your answer
Who will be attending class?
*
Your answer
Do you need to bring an additional person to assist you with a disability in class?
*
Yes, please contact me for further details.
No, I can attend class by myself.
What trainers or training methods/tools have you previously used for training your dog?
Your answer
What do you think a service dog could do to help with the symptoms of your disability?
*
Your answer
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