Become a Canine Ambassador "*" indicates required fields Name* Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Preferred Workshop Session* March 2024 Fall 2024 March 2025 Dog's Name* Dog's Age* Dog's Breed* Date of CGC (or expected date)* Please upload a photo of you with your dogMax. file size: 250 MB.What types of visits are you most interested in: (youth, schools, seniors, special needs students, elderly, hospice, etc.)*Please tell us a bit about your dog and your intereste in bcoming a therapy dog team together.* Δ