---------------------------------------------------------------------------------------------------------- TO RESERVE YOUR SPOT CALL AHEAD (645-6136) THEN MAIL YOUR DEPOSIT OF HALF THE CLASS AMOUNT. YOUR DEPOSIT IS ONLY REFUNDABLE IF THE INSTRUCTOR IS NOTIFIED OF CANCELLATION WITHIN 14 DAYS OF THE CLASS. THANK YOU. Class____________ Start Date__________ Time_________                                  After you have reserved a spot via phone                                          Please Print this form, fill out and sign. Mail to address below with your deposit. 1st Command Dog Training & Grooming Center, LLC 18 Sanrico Drive Manchester, CT 06040 Owners Name  ____________________________________ Street Address  ____________________________________ City, Zip, State  ____________________________________ Home Phone  _______________  Work Phone  _______________   Dogs Name  _________________ Breed  ___________________ Dogs Age  ___________ Dogs Sex (Male) ____ (Female) ____ Spayed/Neutered  Yes  ___  No  ___ Age Spayed/Neutered  ____   Age Obtained  _____ Where did you get your dog?  Breeder  ______  Pet Store  _____  Shelter  ______ Have you owned a dog before?  Yes  _____ No  _____ Have you trained a dog before?  Yes  _____ No  _____ Do you have other dogs at home?  Yes  _____ No  _____ State briefly the goals/problems that brought you to class. _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Do you have hearing or other physical handicaps?  Yes  _____ No  _____ Does your dog have any physical or disability that may affect his/her training?  Yes  _____ No  ______ If your dog has had any illness or skin disorder in the past 6 months, state the nature of the problem and whether treated by a veterinarian. __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________   How were you referred to 1st Command? ____________________________________         ---------------------------------------------------------------------------------------------------------- Question? Call (860) 645-6136