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Breed:  Chow mix
Age:  1 year
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Dog Obedience Program – Info and Feedback Form
Get Notified When New Sessions are Available

Please complete the following information to be notified when new Dog Obedience classes are available at Lollypop Farm.


* Indicates a required field.
* First Name  
* Last Name  
Mailing Address  
City  
State  
Zip  
* E-mail Address  
* Home Phone  

Give Us Your Feedback

In order to help us better understand your needs and shape the Dog Obedience Program, please complete the following information. Please note that your responses are anonymous and will not be associated with your contact information.
Your Dog's Age  
Your Dog's Breed  
Was your dog adopted from Lollypop Farm?   Yes
 No
Have you taken dog obedience at Lollypop Farm before?   Yes
 No
Have you taken dog obedience at other locations?   Yes
 No
If yes, where?  
Where did you hear about the Dog Obedience Program at Lollypop Farm? (Select all that apply.)    Lollypop Farm shelter
 Email from Lollypop Farm
 Lollypop Farm web site
 Phone book
 TV
 Radio
 Newspaper or Magazine
 Friend or Family member
 Other
Why are you interested in the Dog Obedience Program at Lollypop Farm? (Select all that apply.)    Recommendation from friend or family member
 Price
 Class offerings
 Reputation of shelter
 Reputation of instructor
 Convenient location
 Benefits homeless animals
 Discount from adption at Lollypop Farm
 Other
What type of class are you interested in registering for now? (Select one.)  
What types of classes would you be interested in taking in the future? (Select all that apply.)    Puppy Obedience
 Basic Obedience
 Advanced Obedience
 Agility
 Tricks
 Freestyle
 K9 Kids Obedience
 Playtime/Socialization
 Dog Aggressive Dogs
 Scent Tracking
 Rally
 Flyball
 Canine Good Citizen
 Other

What day and time would you prefer to take dog obedience classes? (Select all that apply.)    Weekday - Daytime
 Weekday - Evening
 Weekend - Morning
 Weekend - Afternoon
 Weekend - Evening
Other Comments  
 If you have other comments for us to consider in our Dog Obedience Program, please include them here.
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