Survey - De-Stress Events - San Diego Humane Society

Please provide your contact information:

Name:

First Required	Last Required

Email: Required

Street 1:

City/State/ZIP:

City	State	ZIP

Mobile Phone: Required

Yes, I would like to receive e-mail from San Diego Humane Society.

*2.

Question - Required - What is your Organization or Group's Name?

*3.

Question - Required - Is your organization/group non-profit or for profit?

Non-Profit

For Profit

*4.

Question - Required - Approximate number of people that will participate in pet therapy visits:

*5.

Question - Required - Write in approximate dates you would like to schedule your visit:

*6.

Question - Required - Will this event be held indoors or outdoors?

Question - Not Required - If outdoors, will your organization provide a shade tent or shaded area with seating?

*8.

Question - Required - Do you plan on adding a fundraising component to your event?

Question - Not Required - Any additional comments / information / feedback:

(Maximum response 255 chars, approx. 5 rows of text)