Please list employment beginning with the most recent.

Please include additional employers if current employment has been for less than 2 years.

Criminal History & Background

I, the undersigned applicant (or “student”) for the indicated program for dog training at Canine by Design LLC (or “school”) willingly consent to having Canine by Design LLC conduct a thorough background check for any criminal history. I agree to abide by all rules and regulations set forth by Canine by Design and its representatives communicated to me both in writing or verbally. I understand that Canine by Design, its owners, agents, managers, and subcontractors (collectively and together, the “school”) will not be held liable for any injuries sustained by the students themselves, class members, dogs, or visitors. This includes any dog bites or other dog-related or training related injuries. The service provided by Canine by Design consists of a training course for students and dogs with equipment specific to the training of dogs in the Canine by Design training system, and that no employment is offered or guaranteed.

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I agree that any false statements provided on this application discovered after enrollment shall result in the termination of my program of study at Canine by Design with no refund of monies paid. I agree to abide by the standards for student behavior as set forth solely by Canine by Design while enrolled in the School and any breach of conduct, left to the sole discretion of Canine by Design, shall result in termination of my program of study with no refund of monies paid. Furthermore, Canine by Design reserves the right to terminate the enrollment of any student for the following: excessive attendance issues (tardiness or absenteeism), poor attitude, rough handling of dogs, alcohol use at school, underage alcohol use, being under the influence of alcohol at school and/or while participating in school events, illegal drug use or possession, insubordinate behavior to instructors or staff, malicious behavior, disruptive behavior, or unauthorized removal of school property.

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I HEREBY ATTEST THAT THERE ARE NO WILLFUL MISREPRESENTATIONS, OMISSIONS, OR FALSIFICATIONS IN THE STATEMENTS ABOVE. I UNDERSTAND THAT ANY MISREPRESENTATION, OMISSION, OR FALSIFICATION MAY BE GROUNDS FOR IMMEDIATE REJECTION OR TERMINATION OF MY COURSE OF STUDY WITH CANINE BY DESIGN.

This Agreement may be signed electronically or in hard copy. If signed in hard copy, it must be returned to School for its records. Electronic signatures count as original for all purposes.

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By typing your names as signatures below, the student agrees to the terms and provisions of this agreement.