Company Name* Please attach a hi-res image of your company logo. Drop files here or Select files Accepted file types: jpg, png, Max. file size: 256 MB. Name* Mr.Mrs.MissMs.Dr.Prof.Rev.Mx.None Prefix First Last Title* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Cell PhoneEmail* Website* Sales Link (Can be same URL as website if no separate sales page.)* Name of Product* Description of product:*Please attach a hi-res image of the product. Drop files here or Select files Accepted file types: jpg, png, Max. file size: 256 MB. Retail Value/Price Range of Product* I am interested in:* Tier 1 ($150) Tier 2 ($250) Tier 3 ($500) Tier 4 ($1,000) I understand that this Co-Venture partnership begins with a 90-day commitment, and may or may not be renewed by the Connecticut Humane Society at the end of that term.* I understand.Ticking the box below serves as your e-signature for this partnership.* My e-signature.Today's Date* MM slash DD slash YYYY **Once you hit “submit” you’ll receive a link on the confirmation screen and also by email to complete your payment. Inquiries will be responded to in 3-5 business days.**CAPTCHA
