AGENCY_____________________________________________
AGENCY ADDRESS ____________________________________
___________________________________________________
SUPERVISOR_________________________________________
HOME ADDRESS ______________________________________
___________________________________________________
SEMINAR YOU WILL BE ATTENDING:
___________________________________________________
YOUR NAME AS IT IS TO APPEAR ON THE ATTENDENCE CERTIFICATE (please print clearly)
___________________________________________________
and K-9 ____________________________________________
SIGNATURE
___________________________________________________
PAYMENT METHOD: (ENCLOSED)
CASH________ MONEY ORDER__________ CHECK ________
mo#_________ ck#_________
DATE ___________________________
YEARS OF SERVICE_________________
BRIEF OF YOUR K9 WORK EXPERIENCE:
_________________________________
_________________________________
_________________________________
_________________________________
_________________________________
AGENCY PHONE ___________________
HOME PHONE_____________________
EMAIL ADDRESS___________________
K9 NAME_________________________
AGE OF K9________________________
K9'S TRAINER______________________
BREED OF K9______________________
YEARS OF K9'S SERVICE____________
NOTE TO LETS SEMINAR HOSTS:
If registration forms and seminar payments are mailed to the seminar host rather then to Cindy Hester (LETS Headquarters) A copy of each registration form needs to be provided to LETS Headquarters, care of Cindy Hester within 10 days of the completion of the seminar.