Puppy Application – MAX Potential Dog Training

What is your first name? *

What is your last name? *

What is your email address? *

What is your phone number? *

Street Address *

Apartment, suite, etc

City *

Province *

Postal Code *

Country

What is your dog's name? *

What breed is your dog? *

Which gender is your dog? *MaleFemale

What will their age be when class starts? *

Which veterinary clinic is your dog registered with? *

Will your dog be up to date on all vaccinations by the times classes start? For puppies, we require the second shots to have been administered or scheduled depending on their age. *YesNo

Does your dog have any allergies? *YesNo

What are they allergic to? *

Is your dog currently on any medications? *YesNo

Which medications are they currently taking? *

Has your dog ever aggressively bitten another dog or a person? *YesNo

What happened? *

Is there anything else MAX Potential Dog Training should know about you or your dog? (Special considerations, past medical history, expectations for the class, fears your dog may have, etc)YesNo

Please describe *

Would you like to bundle our online class with your in person class application? We offer this to our in person clients for $50 ($120 value). *YesNo

Are you sure? Online allows other folks in the home that cannot come to class the ability to review the lessons and for you to submit video progress updates to be evaluated anytime. It also comes in handy in case you need to miss a class. Access remains active for 6 months. *Yes, I am sure

How did you find out about us? *FacebookFamily/Friend ReferralGoogle SearchOther

How did you find out about us? *

Course Payment Options

You will receive an email within a few moments of submitting this application. The email will either confirm or deny your application for obedience classes. This email may go into your junk folder. Please contact us at MAXpotentialdogs@gmail.com if you do not see the email after 5 minutes.

If your application is approved, this email will also outline your options to pay the $40 non-refundable deposit. This deposit is due within one business day of our acknowledgement of your approved application. This acknowledgement is included in the email you receive after completing this application.

The remainder of the class fee will be due at the end of the first class. We can accept debit, credit ($5.00 fee for credit) or cash. Please note, we do not accept personal cheques. The remaining balance after the deposit has been paid is $167.00 ($180 + $27 HST = $207 - $40 deposit = $167) for in person classes and $224.50 ($230 + $34.50 HST = $264.50 - $40 deposit = $224.50) if you opted to add online classes.

The total fee for a set of six obedience classes is $207 taxes included or $264.50 including online access.

Agreement *By checking this box, I certify that all information I have provided is true. I have also read and agree with the Waiver. You are not required to print or sign the waiver at this time.