Super-k9.com - Seminar Registration Form

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Michele Crouse, CPDT

Member of
Association of Pet Dog Trainers

Denison, TX
(903) 465-0069
michele@super-k9.com

To register for an upcoming seminar, please complete the form below and click Submit. Please note that your registration is not complete until I receive your full payment and then send you a confirmation.

*required field

Seminar:*

Select the Days:*

$350.00 for all 3 days
$275.00 for 2 days
$150.00 for one day

Friday
April 25th

Saturday
April 26th

Sunday
April 27th

Day 1

More to follow

Day 2

More to follow

Day 3

More to follow

Your Contact Information:

My Privacy Policy - Super-K9 is committed to protecting your privacy and will by no means share this information with anyone without your consent.

First Name*
Last Name*
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone Number*	(xxx-xxx-xxxx)
Alternate Phone Number	(xxx-xxx-xxxx)
Email*	(username@domain.com)

Do you require CEUs from IAABC?
Yes No

Do you require CEUs from CCPDT?
Yes No

Lunch:

Lunch will be provided on both days; however, if you have require a special diet you may wish to bring your own. Please choose one of the following lunch options:

I would like the provided lunch
I would like the provided vegetarian lunch
I will be bringing my own lunch

Additional Info:

Use the box below to include any additional information, questions, and/or comments that you would like to submit with this form. Be sure to enter valid contact information above if you need a reply!