Instructor Training Application

Instructor Course Application

A deposit of $500 is required to hold your place in this class. Payment may
be made by Visa/MC/AMEX online. After you have filled out the application, you will be given a link to pay the deposit online.

You may also pay the deposit by check. All checks should be made out to NEADS and mailed to:

Instructors Program
NEADS
PO Box 213
West Boylston, MA 01583

Required fields are marked with an asterisk *

* Full name:
* Address:

* City
State or providence:	(leave blank if this does not apply)
Zip code:	(leave blank if this does not apply)
* Country:
* Phone:	(Include area and country code if applicable)
Fax
* E-mail:
	Please answer the following questions in the space provided:
	* 1. Describe any animal-related experience you have had:
	* 2. Describe any experience you have had working with people who are deaf or physically disabled:
	* 3. List and describe the reasons why you want to attend NEADS Instructors Course for Service Dog Training: