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First Name *

Last Name

Phone *

Email *

Provide Your Address

Street Address *

City *

State *

Zip Code

Enter Applicant Details

Date of Birth *

Are you left or right handed? *

Have you graduated from high school or obtained your GED? *

Yes

If YES, please list the school name and graduation year:

Enter Emergency Contact Details

Emergency Contact *

Phone Number *

Relationship *

Share Your Animal Grooming Experience

Have you attended a groom school prior to this? If so, when & where? *

Do you have any grooming experience? If so, when & where? *

Have you worked with animals before? If so, when & where? *

Share Your Goals & Physical Readiness

What are your goals for this class?

What are your plans post-graduation with your new skills?

Do you have any physical limitations that would impair you from grooming dogs?

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