Canines for Therapy Registration Wilmington, NC ONLY
Complete the information to register for an upcoming Canines for Therapy class in Wilmington, NC.
Class Dates: January 17, 2012, April 17, 2012 Please note an American Kennel Club Canine Good Citizen Evaluation must be completed for your dog prior to the first night of class. Course & Course Manual, Team Assessment, Registration and Background fee is $200.00.
A $50.00 deposit is required to hold your registration; $50.00 on first night of class, balance due on night of assessment.
First Name:
Last Name:
Address:
City, State, Zip:
Day Time Telephone Number:
Email:
Animal's Name:
Animal Breed and Age:
Has your dog completed the AKC Canine Good Citizen Evaluation?
Yes No
Is dog spayed or neutered?:
Veterinarian:
Are you or is your spouse active military?:
How did you hear about Carolina Canines?:
