Membership Application Form | MSDI

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Membership Application Form

First Name

Last Name

Address

Mailing Address

Phone Number

Email

Thank you for your interest in MSDI membership. Please answer the following questions

1. Please describe the reasons why you are applying for MSDI membership

2. Are you a dog trainer? *

Yes

No

3. Are you interested in service dog training? *

Yes

No

4. Do you have a service dog? *

Yes

No

5. Are you interested in having a service dog? *

Yes

No

The annual membership fee is 2400$ (*non-refundable), please indicate your prefer form of payment: *

Check

Money transfer

Credit Card

*After filling and signing the application form, we will contact you and charge you for
the accreditation application fees

Your Signature

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