Southwest Region Presentation Request Form

1. General Information

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If you respond and have not already registered, you will receive periodic updates and communications from Canine Companions for Independence.

 

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Question - Required - Desired presentation date




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Question - Required - Alternate presentation date




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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.