Southeast Region Presentation Request Form

Thank you for your interest in scheduling a presentation by a representative of Canine Companions for Independence. Before completing the presentation request form, please take a moment to review the following information.

  • The dogs that live on our campus are going through an advanced and regimented period of training and are not permitted to accompany our speakers to presentations. For the most part, we rely on our graduates and volunteer puppy-raisers to give presentations on our organizationís behalf; therefore, our ability to provide a dog for a presentation or an event often depends on our graduatesí and/or volunteersí availability. We will make every attempt to bring an active assistance dog or a puppy-in-training to a presentation or event, but in cases where a Canine Companions for Independence staff member gives the presentation (rather than a graduate or puppy-raiser with a dog), this may not be possible.

  • Because we depend on graduates and volunteers to give presentations for our organization, we prefer to not ask them to commit to doing a presentation too soon or too far in advance. Please allow at least 6-8 weeks advance notice for presentations, but not more than 4 months. Additionally, we prefer not to ask our graduates and volunteers to travel more than an hour to a presentation.

  • We do have graduates and puppy raisers that live throughout in the Southeast region, so we frequently are able to accommodate requests for presentations in areas outside of Orlando. However, since we prefer not to ask our graduates and volunteers to travel more than an hour to a presentation, we may not be able to accommodate your request if we have no graduates or puppy raisers living within an hour of the presentation location.

We appreciate your patience and understanding.

If you have any questions or would like to schedule a presentation, please fill out our online presentation request form, or contact Martha Johnson at majohnson@cci.org or (407) 522-3305.

* required information
 Presentation Request Form 

 
Please complete this form if you are interested in a representative of the Southeast Regional Center of Canine Companions for Independence conducting a presentation to your organization.
Name of Group or Business:
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
Email:*
Phone:*
How did you hear about us?:
To give us a better understanding of your needs, please complete the following:
Time:*
Preferred Date:*(mm/dd/yyyy)
Day of Week:
Type of Group:*
Audience Type:*
Number of attendees:*
Presentation Type:* Booth/Exhibit
Speaking Presentation
Demonstration
Time Allocated for Presentation/Event:* 30 minutes
One hour
Other *please explain in Comments field
Is the presentation location accessible for wheelchair use:* Yes
No
Is the presentation:* Indoors
Outdoors
Is there a TV/DVD available for showing a short video:* yes
no
Will a table be available for displays:* Yes
No
Comments:
Thank you for taking the time to fill out this form. You will be contacted by a staff member of the Southeast Regional Center to confirm the requested date and time of the presentation within the next five business days.
        
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