Spring 2012 Wayne County Class Registration Form
May 2 – June 13, 2012 (7 weeks)
Held at: Palmyra Macedon Middle School, 163 Hyde Pkwy, LGI Room, Palmyra, NY
Class Selection: ____ Good Dog (one year and older) 
5:45-6:45 PM
____ Puppy Kindergarten (7-16 weeks of age) 7:00-8:00 PM
____ Teen Puppy (5-11 months of age) 8:15-9:15 PM
Cost: $90 ($65 for HSWC Adoptees)
Please provide contact Information
Name _________________________________________________
Address _______________________________________________
City _______________State ___________ Zip Code____________
Email Address __________________________________________
Home Phone _________________ Cell Phone _________________
Work Phone _________________Ext. ________Fax Number ___________________
Please provide following information
Dog's Name _______________ Breed ________________________ Dog's Age _______ Sex: Male ___ Female ___
Good with other dogs? ____Yes ____ No If No, brief explanation _________________________________________
Spay/Neuter: Yes _____ No _____ Vet's Name _______________________________________________________
Vet's Phone ____________________________________
Humane Society of Wayne County (HSWC) Animal ID #______________________
Date Adopted ___________________________ (Adoption must be within one year from start of first class)
Registration fees are non-refundable once classes start. Refunds requested before classes start will be subject to a 15% processing fee. Returned checks are subject to a $25 service charge.
Please arrive 10-15 minutes prior to the start of the first class.
Bring vaccination record to first class. Record will be returned to you. NO DOGS IN FIRST CLASS.
Send completed registration form and check to:
Paws-i-tive Behavior
27 Cambridge Court
Fairport, NY 14450.
