Delta Workshop Reg form

Delta Society® Pet Partners® Team Training Workshop

Offered by: a Delta Society affiliate group and Jack’s DOGs

Workshop Dates:         Saturday, September 11th and Saturday, September 18th, 2010
Workshop Time:           8:00AM – 4:30 PM both days
Workshop Fee:             $75 ($65 for VIPaws and Jack’s DOGs volunteers)
                                **$10 Early Bird Discount if received by August 15**
Workshop Location: Ivy Tech Bloomington Main Campus
                                           200 Daniel’s Way, Bloomington, IN 47404

Contact People/Instructors: Sarah DeLone educate@bluemarble.net 812-335-9453
Jan Nowicki jacksdogs@iquest.net 317-882-6122

** This course is for handlers only. Please leave your animal companion at home.**

Learn the skills needed to visit safely with your animal in hospitals, nursing homes, classrooms, and other
facilities. Successful completion of this course, in instructor-led or home-study format, is required for
registration as a Pet Partner.

Topics include:

· Selecting and preparing animals for visits.

· Identifying and decreasing stress in animals.

· Animal health and safety.

· Special needs of client groups.

· Interacting with special people.

· Facility health and safety codes.

· Patient confidentiality.

Payment and registration form must be received by September 1, 2010 to guarantee your
spot!! Forms received after September 1 are subject to space and material availability
Mail to: MCHA, P.O. Box 1334, Bloomington, IN 47402

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Delta Society® Pet Partners® Workshop Registration Form, Sept 11 & 18, 2010

Name: ______________________________________________________

Address: ______________________________________________________

___________________________________________________________________

Phone: ______________________ E-mail: ________________________________

Payment enclosed: _________$75 __________$65 (VIPaws and Jack’s DOGs members)

Checks should be made payable to: MCHA (Pet Partners workshop in memo line)