South Central Region Presentation/Event Request Form

Thank you for your interest in learning more about Canine Companions for Independence. We try to accommodate as many presentation and event requests as possible but rely heavily on our volunteers, therefore, our ability to accommodate each request depends on our volunteer's schedules and the presentation location. We ask that you please submit your request at least 4 weeks in advance. Please keep in mind we are generally not able to confirm a presenter until two weeks before the date.

1. Contact Information for Event Organizer

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What's this?

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Question - Required - Please let us know what type of audience will attend. (Mark all that apply)

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Give Independence Year-round

For a limited time, if you make a monthly gift of $25 or more, you'll receive a Canine Companions. Give a Dog a Job double-wall tumbler as a thank you.