Dog Training Club of Champaign-Urbana Class Registration Form

DOG TRAINING CLUB OF CHAMPAIGN-URBANA, INC.

REGISTRATION FORM

To register, fill in this form and press the "Send Registration" button.
(Our registrar can be reached directly at levifm@aol.com if you have questions.)
Bring signed proof of inoculation to the first class meeting.

CLASS INFORMATION:
Not all classes are offered every semester. Please check our schedule page for complete information.
The registrar does maintain a waiting list for popular classes.

If you register online, you will receive a confirmation email.
If you have not received this confirmation after 5 days, please email our registrar, Charlotte Craft, levifm@aol.com
Enrollment ends one week before classes start.
You will receive notification of your enrollment during the week prior to the orientation/first meeting of your class.
Fee must be paid in advance to the registrar or at the first class meeting to confirm your enrollment.

HANDLER INFORMATION:

Name:
Address:
Phone:		E-Mail:

DOG INFORMATION:

Name:
Breed:
Sex:	M F
Neutered:	No Yes
Age:
Previous training with this dog:	Tell us what you've done.

Have you owned a dog before?	No Yes
Have you trained a dog before?	No Yes
If so, to what level?	Tell us what you've done.
What do you like best about your dog?	Answer here.
What do you hope to achieve from this class?	Answer here.

HEALTH INFORMATION:
(Give dates for shots given)
Proof of inoculation, signed by your veterinarian, will be required at your first class meeting

Distemper:		Rabies:
Parvo:		Corona:
Veterinarian's name:

WE LOOK FORWARD TO MEETING YOU AND YOUR DOG!

Don't want to register via the web form?
Download a Microsoft Word copy of the registration form by CLICKING HERE.
Print & fill out the form. Mail it with the course fee to

DTCCU Registrar
c/o Charlotte Craft
1706 CR 3200 N
Rantoul, IL 61866

| Homepage | Courses | Class schedule |

This page last updated 20 May 2008
http://dtccu.prairienet.org/

Session:
Class Desired:
Day and Time:
Other info:
Registration Fee:
Fee Paid?:	No Yes