"Pilot Dogs Live" Off Site Request Form
Please provide your details and preferences for your onsite visit request.
Primary Contact Name
*
First Name
Last Name
Primary Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Primary Contact Email
*
example@example.com
Organization or Club Name
*
How many people will be attending the onsite event?
*
What level of presentation are you interested in?
*
We prefer only a presentation about the organization, no guide dog demonstration
We prefer a guide dog demonstration only (trainer + dog)
We prefer a combination of both
Date of Event
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Start Time of Event
*
Hour Minutes
AM
PM
AM/PM Option
End Time of Event
*
Hour Minutes
AM
PM
AM/PM Option
How much time is allotted for our presentation?
*
What is the name of the facility where the event is being held?
*
What is the full address including zip code?
*
Have we presented to your organization before?
*
Yes
No
If so, are there any best practices or specific protocols that you would like us to be aware of?
Submit Request
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