Student Profile
The class instructor reviews profiles prior to the starting date in order to help meet the needs and expectations
of each individual participant. Please complete the profile as accurately as possible. Return it with your
application.
Owner’s name: _______________________________________________
Puppy/Dog’s Name_________________________ Age________________
Contact #: __________________________________ Email:_____________________________
Is puppy/dog spayed/ neutered ____________At what age was dog spayed / neutered __________
Breed / Mix_________________________ How long have you had the dog? ________________
1. List all household members:
# of Adults __________ # of Children/ Ages _________________________________
# of other pets________________ Pet types / Ages _____________________
2. Dog was acquired from: (Please circle): Breeder/ Kennel/Rescue Shelter/ Pet Store/ Other
_____________________________________________________
3. Have you previously owned a dog?
_______ Yes_________ No ______
4. Have you attended a dog obedience class before?
Yes __ No __
If "Yes", Where___________________________________
5. Have you ever competed with a dog in obedience events? Yes __ No __
If "Yes", have you ever completed an obedience title with a dog?
Yes ___________ No _______________
6. What do you want to accomplish in this class? ___________________________
7. List commands your puppy/ dog will currently obey, if any:
__________________________________________________________________
8. What do you like best about your puppy/ dog?
__________________________________________________________________
9. On a typical day, indicate the percentage of time your dog is:
Indoors ______ % Outdoors _______% without people____________%
10. Do you currently use the training method of crating your dog?
Yes __ No __
11. Do you have a fenced yard?
Yes ______No _______
12. What is your primary method of exercising your dog?
________________________________________________
13. Please circle all the words below that describe your dog: Shy - Fearful - Bites People Bites other animals -
Aggressive - Growls - Pushy - Destructive - Noisy - Calm - Obedient - Protective - Excessive Energy - Excessive
Barking
Other ________________
14. Please use the rest of this form to provide the instructor with any additional information about your puppy or
dog that may be important to help meet your goals for participation in this class.
THIS PROFILE MUST BE COMPLETED AND SENT WITH YOUR
APPLICATION AND CLASS FEE
PLEASE COMPLETE BOTH THE
APPLICATION AND STUDENT PROFILE
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Delaware Valley German Shepherd Dog Club Training Application
*Please print and return both the application and student profile with your check payable to DVGSDC
Member: American Kennel Club
Member: Pennsylvania Federation of Dog Clubs
All fees are payable to: DVGSDC. Proof of Vaccinations Required. Student & D0G Profiles must accompany this
application for processing. Mail to: Mary Flounders, 638 Gorgas Lane, Philadelphia, PA 19128. You will receive a
confirmation with instructions prior to the start of your class.
Training Director: Mary Flounders Instructor: Paulette McBride
Classes are held at: Andorra Shopping Center, 8500 Henry Avenue, Philadelphia, PA 19128
Owner Name: ________________________ Home #_____________
Address: _____________________________ Email: ____________
City, State, Zip: ________________________ Cell #: _____________
Dog’s Name: __________________________ Breed/Mix: _________
Age of Dog: _____ Weeks/Months Sex of Dog: Male / Female
Class Choice (please consult training schedule for classes and fees):
1st choice ________________________________
2nd choice _______________________________
For questions and upcoming classes, please call Mary or Paulette @: 215-482-4571 or 610-789-5480 or visit our
website at www.DVGSDC.com.
Waiver: I certify that I have no current or pending disciplinary actions with the American Kennel Club and that I will
abide by the rules and regulations of the Training Classes. I waive and release DVGSDC and Andorra Shopping
Center, their employees, members, volunteers, and directors from any and all liability of any nature for injury or
damage which I or my dog may suffer while attending any training session or other function of this training facility or
while on the training grounds or surrounding areas. Upon acceptance of my application I agree to indemnify and
hold harmless DVGSDC and The Andorra Shopping center, their employees, members, volunteers and directors
from any and all claims of injury or damage by any member of my family or any other person accompanying me to
any training session or function of this training facility or while on the training grounds or the surrounding area. I
hereby give DVGSDC permission to use my name & any photograph of me and or my dog in any way it deems
appropriate for informational and training purposes relating to DVGSDC activities. Such use by DVGSDC includes,
but is not limited to, use in its newsletter or any other publications, use in newspaper or magazine articles about
DVGSDC, use in videos or on web pages or internet sites for training or informational purposes concerning
DVGSDC, or use in any other written or non-written informational materials concerning DVGSDC and its activities.
Printed Name: __________________________Signature:
Date: ______________________________
Information must be completed, application signed and check included or registration cannot be processed