Below is a sample of the emails you can expect to receive when signed up to Madonna.
| Data Name | Data Type | Options |
|---|---|---|
| Leave this field blank | ||
| First name | ||
| Last name | ||
| Phone | ||
| Home address | ||
| City | ||
| Zipcode | ||
| Lincoln Campus | ||
| Are you currently employed? | ||
| Yes | ||
| No Are you retired? | ||
| Yes | ||
| Have you ever been employed by Madonna Rehabilitation Hospitals? | ||
| Yes | ||
| Do you have any family members who are employed by Madonna? | ||
| Yes | ||
| Sex | ||
| Male | ||
| Female Have you began the process to have your dog certified? | ||
| Yes | ||
| Has your dog had any formal obedience training? | ||
| Yes | ||
| Is your dog on regular,mpnthly flea preventive/treatment? | ||
| Yes | ||
| Background Information Please answer the question below as completely as possible. Have you ever been convicted of a felony? | ||
| Yes | ||
| Have your ever been convicted of abusing, neglecting or mistreating individuals or animals? | ||
| Yes |