Puppy Intermediate Class Application About YouYour Name(Required) First Last Your Phone(Required)Secondary Phone(Required)Your Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Your Email Address(Required) Email Address Confirm Email Address How did you hear about this class?Any other pets in the household? Please list:(Required)Other adults in the house? Please list:(Required)Children in the house? Please list name and ages:(Required)DOG INFODog's Name(Required) First Breed(Required)Date of Birth(Required) MM slash DD slash YYYY Gender(Required) Male Female Veterinarian*(Required) First Vet Phone(Required)*Dogs are required to be current on rabies, bordetella and distemper vaccinations. This paperwork must be provided along with this registration form in order to attend class.Does your dog have any allergies?(Required) YES NO If Yes, please list:Is your dog spayed or neutered?(Required) YES NO Disposition: (Select all that apply)(Required) Shy Outgoing Calm Energetic Wallflower Nervous Playful Grumpy Vocal Mischievous Sociable Curious Skittish Reacts/barks or growls at people or dogs?(Required) YES NO SOMETIMES If Yes or Sometimes, please describe:Has your dog ever bitten a person?(Required) YES NO If Yes, please describe:Has your dog ever bitten another dog?(Required) YES NO If Yes, please describe:*This class is not for aggressive/reactive dogs. Muddy Paws has the right to refuse training to those who pose a threat to any staff, dogs or dog owners. If you are questioning whether your dog is appropriate for class, don’t hesitate to reach out. We can chat about it!Has your dog attended any training courses before?(Required) YES NO If Yes, which course and where?Is there anything else we should know about your dog? 52313
