Delta Society Pet Partners Team Training Workshop Registration Form
Workshop Date : April 12 - 13, 2008
You must leave your pet home on this day
Evaluation Date : April 27, 2008
BY APPOINTMENT ONLY
Cost : $65.00 includes lunch and workshop

NAME_________________________
ADDRESS_______________________
CITY_______________________________STATE__________ ZIP______
BEST NUMBER TO REACH YOU AT______________________________
PETS NAME___________________________________MALE___FEMALE___
SPECIES________________________BREED___________
AGE__________SPAYED/NEUTERED______(Y/N)
HOW LONG HAVE YOU OWNED THIS PET?_________

DO YOU OR YOUR ANIMAL HAVE ANY EXPERIENCE WITH PET ASSISTED THERAPY?
AT ANY TIME HAS THIS ANIMAL EVER SHOWN AGGRESSION?
WHY DO YOU THINK YOUR ANIMAL WOULD MAKE A GOOD THERAPY PET?

There are only a limited number of seats available.
Reservations will be accepted on a first come/ first serve basis.
We will be holding additional workshops throughout the upcoming year.
Please call for additional dates.
PAYMENT IS DUE AT TIME OF REGISTRATION

Mail registration form and check to:
RISPCA Pet Assisted Therapy Program
186 Amaral Street
Riverside, RI 02915
401-438-8150