Tell Us More About You

Thank you for your commitment to improving access and safety for all Americans with disabilities who rely on task-trained service dogs. We'd love to know more about you. Please share more about yourself below!

First Name *

Last Name *

Email *

Address One *

Address Two

City *

State * AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip *

1. Why are you passionate about service dogs? *

2. Why do you support Canine Companions? * I'm a donorI'm a volunteerI'm a graduateI know someone with a service dogI care about disability rights

3. Have you previously participated in grassroots advocacy efforts with other organizations? * YesNo

4. If yes, tell us more about your previous grassroots advocacy experience -

5. Which types of advocacy actions are you interesting in taking? * Attending legislator townhall meetingsMeeting with legislators in their district officeSpeaking publicly (educational or giving testimony)Calling a legislator's officeParticipating in advocacy webinarsSending a "letter to the editor" to your local newspaperNone of the above

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