Shares Name* First Name Last Name Email Address* Town of Residence State of ResidenceCTAlAZARCACODEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYDistrict of Columbia - DCBirthdate MM slash DD slash YYYY Have you adopted a pet from the Connecticut Humane Society? Yes No Are you a volunteer at the Connecticut Humane Society? Yes No Are you a donor? Yes No Are you a… Dog Person Cat Person I love all animals What programs interest you? Keeping pets in homes Helping homeless pets Education and outreach Events How did you hear about CHS? Internet Social media TV, Radio, Print Media From a supporter or volunteer At an event CAPTCHA Shares
