Workshop Request

Potential Sponser/Organization: Please fill out the following information, or download a printable form here.

* Required fields
Name *
E-mail Address *
Preference for Workshop Date(s): *
Organization Name: *
Address: *
Contact Person:
Primary Language:
Fax:
Phone:
Preferred Method of Contact: *	Phone E-mail Either
Best Time to Reach You: *	Morning Afternoon Evening Any
Type of Organization	Private Practice Facility Local or National Therapy Association University Program Community Based Human Service Pet Therapy/AAT Club or Organization Assistance Dog Training Organization
I would like more information about:
Expected Attendees: (ex: teachers, OT, social workers, assistance dog trainers)
Estimated Number of Participants:
Requested Time for Workshop:
What airport would speaker & dog fly into?
Overnight accommodations: (Name & address of hotel:)
How long will it take to drive to the airport after training?
	We can provide AV equipment.
	We can provide a room with a chevron or "U" shape.
	We can provide an area for registration, reference & sales tables.
	We can provide the use of dogs, wheelchairs and walkers, etc. for activities upon lecture content and needs.
Please let us know anything else that will help us to provide the type of training that would be useful to you. Be as specific as possible:

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Dogwood Therapy Services, Inc., 7818 Pan American Freeway NE, Albuquerque, NM 87109

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