0Shares0 0 Name* Mr.Mrs.MissMs.Dr.Prof.Rev.Mx.None Prefix First Last Program or Venue Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email* Phone*Preferred form of contact.*PhoneEmailBirthdate Date Format: MM slash DD slash YYYY How did you hear about CHS?CHS SupporterCHS VolunteerCHS EventFriendsEmployerSocial NetworkDirect MailingsEmailsPrint AdvertisementsRadioFlyersOtherIf other, please enter how you heard about CHS.Name of Group*Age of Group Members*Number of People in Group*What type of adult program would you like?*All About CHSPet Boredom BustersBeyond the Breed: Exploring Dog DNAPet Savvy CitizensPreferred date to schedule your program.*Preferred time for your program.*Length of presentation.*30 minutes45 minutes60 minutesHow do you want your program presented?*VirtuallyIn-personProgram Fee*$75 cash$75 check$75 credit cardCAPTCHA 0Shares0 0