Canadian Dog Trainers Registration Form

(Non Registered Business Only)

Payment Amount $ 75.00

Fill the form below - you will then be automaticaly redirected to on-line Payment at Pay pal

If not a government registered business or qualified DBA (Doing Business As), leave "Business Name" field blank

First Name:
Last Name:
Username:
Password:
Business Name:
Address:
City:
Province:	Alberta British Columbia Manitoba New Brunswick Newfoundland Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan
Postal Code:
Closest Major City:
Telephone:
Website:
Email:
Years in business:
Years as a trainer:
Name of person you learned from:
Name of the school you learned at:
Telephone of the school you learned at:
Payment Type:	Cheque/Money Order: PayPal:
	Code: