If you have already paid your fees, please complete this form and email it prior to your consultation. If you have not yet done so click here. For items you may not know or do not apply please put N/A. All items are vital to help properly assess your situation. Each appointment is geared to dealing with one area of focus. You should book an extended appointment if you want to discuss additional topics. Visit here if you need the printable form or you can return to the index now.
Today's Date: Type of Consultation Desired: Phone Email Appointment How did you find our site? Referral Another Website Link Search Engine Chat Room Printed Material Email Other
Although we cannot always guarantee your choice, please give us your preferred day and time slot for appointments You will be emailed an appointment date and time which you must confirm. This does not apply to email consultations.
Monday Tuesday Wednesday Thursday Friday Saturday Not Applicable Preferred Day Morning Early Afternoon Mid Afternoon Late Afternoon Early Evening Evening Not Applicable Preferred Time Slot
This form is for career consultations only. Visit this page for appropriate form for behavior topics.
GENERAL INFORMATION
Name: email address@host: Mailing address (Street or PO Box): City: State: Country: Postal(Zip)Code: Your Time Zone Pacific Central Mountain Eastern Other Daytime Phone: Evening Phone: Emergency Contact: Emergency Phone:
List any degrees or credentials you currently hold:
What are some of your former and current occupations?:
:
Have you ever attended any animal training program or behavior seminar before? Yes No If yes, did you complete the program? Yes No Certificate awarded? Yes No Describe/list programs or seminars and the party conducting them:
INTEREST AREA(S) : 1) Briefly describe your main area of interest 2) How long has this been an interest? 3)What steps have you taken to move toward this interest? 4) What other areas of interest do you have? 5) Explain why you have these particular interests and why you want to pursue them 6) What skills do you have that support this interest?
Please list animal experience you have: Breed/Species/Where obtained
Your ideal living environment is: House Duplex Apartment Townhome/Condo Retirement Ranch Other Would your residence have a private yard or garden? Yes No Your ideal salary is: <20,000 <30,000 <40,000 <50,000 <60,000 <70,000 <80,000 >100,000 Do you have a family or are you married? Yes No If yes, does your family support your interest? Yes No Would you be willing to relocate? Yes No Given your family status and other concerns COULD you relocate anywhere? Yes No
Describe your ideal job:
PERSONAL INFORMATION
Sex: M F Heritage: Birthdate:
Any allergies, health or physical problems? Yes No Please Explain:: Are you on medication? Yes No If yes, What? & Why?
Have you ever been seriously injured Yes No or ill? Yes No If so, please explain: Please describe yourself: Analytical Assertive Confident, Assured Reserved Outgoing Expressive Amiable