Humane Society of Missouri - http://www.hsmo.org

Humane Society of Missouri - ../photos/humphotosmall3.jpg?62

Step 1 of 3: Register for Your Class

Please note: Unfortunately, class registration fees are not refundable. If you register
for a class and are unable to attend, we will be happy to provide you credit for a future class.

Please complete the following form. Fields with an asterisk * are required.

Today's Date

1. Select a Class

-BAT:101, 07-28-2008Mon(CV)6:30pm (1weeks) Cost $20.00
-BAT:101, 07-31-2008Thur(HQ)6:30pm (1weeks) Cost $20.00
-BAT:101, 08-11-2008Mon(CV)6:30pm (1weeks) Cost $20.00
-BAT:101, 08-25-2008Mon(CV)6:30pm (1weeks) Cost $20.00

2. Owner's Information

*First Name

*Last Name

*Street Address

*City

*State

*Zip Code

*Email Address

*Home Phone

ex. [xxx-xxx-xxxx]

Work Phone

ex. [xxx-xxx-xxxx]

3. Pet Information

*Name

*Breed/Type

*Age

*Sex

Male Female

*Spayed or Neutered?

Yes No Unsure

*Has your dog ever growled at or
tried to bite a person?

Yes No

*Does your dog bark or
growl at other dogs?

Yes No

4. Additional Information

Name(s) of all family
members attending the class:

*Are You a Humane Society
of Missouri employee?

Yes No

*Are You a member of the Greater
St. Louis Training Club?

Yes No

*How did you acquire your dog?
(Please check one.)

	Humane Society of Missouri
	Animal Protective Association of MO
	St. Louis City Animal Center
	St. Louis County Animal Control
	Pet store
	Found/stray
	Friend/neighbor/co-worker's dog had pups
	Breeder
	Other

How did you select your dog?
(Optional, please describe)

5. Agreement

*I agree

If you found this information useful, please help the animals in our care by making a secure online donation. The animals send their thanks.

2004 Humane Society of Missouri (314) 647-8800
Headquarters: 1201 Macklind Avenue St. Louis, MO 63110