Canines for Therapy Registration
Wilmington, NC ONLY

Complete the information to register for an upcoming Canines for Therapy class in Wilmington, NC. 

Please note an American Kennel Club Canine Good Citizen Evaluation must be completed for your dog prior to the first night of class.

Course fee is $145.00.  A $50.00 deposit is required to hold your registration.

Class Date:

Sept. 13, 2011

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?:

     
Please mail registration deposit to:
 
Canines for Therapy
PO Box 12643
Wilmington, NC 28405


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