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Contact the North Central Region

Name*
First Last
Email*
Address*
Street 1 Street 2 City State Zip
Phone*
I am interested in:*
- Advocacy and Awareness
- Applying for a service dog
- DogFest
- Events
- Giving Opportunities
- Media Interview
- Presentation
- Tour of Center
- Volunteering
PRESENTATION INFORMATION
Event name
Group or business name
Event date
Event time

: Hours

Minutes

AM/PM
Event contact email
Event is virtual
- Yes
- No
If no, please enter location information*
Street 1 Street 2 City State Zip
Event location has given consent to host this event on the specified date(s) and time(s)*
- Yes
- No
Location is wheelchair accessible*
- Yes
- No
Presentation will take place*
- Indoor
- Outdoor
Location allows assistance dogs and puppies*
- Yes
- No
Comments
TOUR OF THE TRAINING CENTER
Canine Companions is closely monitoring developments with the coronavirus (COVID-19). We are taking precautions to limit its effect on our operations, including cancelling or postponing many large group events and non-essential activities, including most travel, public campus tours and on-campus large group activities. We ask that you help us by avoiding visits to campus if you are sick or exposed to anyone sick. And please be patient with us as we may reschedule some appointments and activities. We look forward to being able to see you and serve you in our usual fashion as soon as possible!
VOLUNTEERING
Type of volunteering I am interested in:
- Event support
- Facility and grounds maintenance
- General office support
- Outreach booths
- Photography and videography
- Puppy raising
- Puppy sitting and puppy fostering
- Team Training lunch providers
Comments
DOGFEST
I am interest in doing the following for DogFest:
- Volunteering
- Becoming a sponsor
- Fundraising
MEDIA INTERVIEW
Event name
Group or business name
Interview date
Interview time

: Hours

Minutes

AM/PM
Interview contact email
Is the interview virtual?
- Yes
- No
If no, please enter location information:
Event location*
Street Address Address Line 2 City State ZIP Code
Event location has given consent to host this event on the specified date(s) and time(s)*
- Yes
- No
Location is wheelchair accessible*
- Yes
- No
Presentation will take place*
- Indoor
- Outdoor
Location allows assistance dogs and puppies*
- Yes
- No
Comments
- Yes, I would like to receive communications from Canine Companions®.