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

Comments