Intake Form - Canines & Company

Intake Form

You can fill out this form to give us some preliminary information we can use to get you set up in our system. This will help us get to know some background information we can use to more effectively assist you with your training needs. Once you've completed the intake form, we'll assign you a student ID and you can begin to register for any of the classes offered by Canines & Company (including private lessons).

Name *

First

Last

Address *

Address 2

City *

Province *

Postal Code *

Phone Number *

Email *

Confirm Email

Canine Profile *

Breed *

Gender *

Age *

Current Vaccinations Received: *

NOTE: Current rabies vaccination is mandatory for dogs who are 12+ weeks old.

Lesson Type(s): *

Doggy Daycare
Private Lesson
Class Registration

I am looking to: *

Are you a current, or returning student? *

Are you a Punch Card Pass holder? *

PC30 = 30 Punch Card Pass | PC50 = 50 Punch Card Pass

Additional comments, concerns, or information to provide:

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