KSDS Assistance Dogs, Inc. Program Request
Let us know how we can provide you with more information about KSDS Assistance Dogs! We provide programs, presentations, and speakers for in-person and virtual events.
Point of Contact
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First Name
Last Name
Organization Name
Phone
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Area Code
Phone Number
E-mail
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Program location
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Briefly describe what you are interested in learning about during our program?
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Proposed date/time of program
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Month
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Day
Year
Date Picker Icon
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Hour
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10
20
30
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50
Minutes
AM
PM
AM/PM Option
Additional dates that would work if the proposed date is unavailable
Proposed length of program
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15 - 30 minutes
30 - 45 minutes
45 - 60 minutes
Other
If other, how long would you like the program to last?
Number of attendees
Average age of attendees
Would you like us to bring one of our assistance dogs in training to the program?
Yes
No
Would you like to be added to our mailing list? Please note: we do not share contact information with third parties!
*
Yes
No
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