PRO-TRAIN SERVICE DOG APPLICATION FORM
Pro-Train, 1544 Avohill Dr., Vista, CA 92084, Phone 1-877-BAD DOGS

    Name*:

    Address:

    City:

    State:

    Zip:

    Date:

    Email Address*:

    Date of Birth:

    Telephone(Day):

    Telephone(Evening):

    EMPLOYMENT INFORMATION:

    Current Employer:

    Occupation:

    Address:

    City:

    State:

    Zip:

    GETTING TO KNOW YOU

    Your Disability:

    Your Limitations:

    Have you ever had a Service Dog?
    YesNo

    If "Yes" explain:

    What would you like the Dog to do for you?

    LIVING ARRANGEMENTS:

    What type of dwelling do you reside in?*

    Others(Please Explain):

    Do You*

    Other Pets:

    OTHER MEMBERS OF YOUR FAMILY:

    Name:

    Relationship:

    Age:

    Full Time/Part Time
    FTPT

    Name:

    Relationship:

    Age:

    Full Time/Part Time
    FTPT

    Name:

    Relationship:

    Age:

    Full Time/Part Time
    FTPT