TheraPets Event Request

This form is for TheraPets Event Requests only. If you are a facility interested in ongoing/recurring visits, please fill out this form.

---

Person Submitting Request

Name (First/Last) *

Title *

Email *

Phone *

Point of Contact Day-of Event (if different from above)

Point of Contact Name (First/Last)

Title

Email

Phone Number

---

Event Information

Event Name/Organization *

Event Website

Date of Event (must be 45 days prior) *

Event Start Time *

PLEASE NOTE: Due to current high demand/limited volunteer availability, TheraPets events restricted to 90 minutes until further notice.

Event End Time *

Event Date: 2nd Choice

Demographic *

• Children (toddler-kindergarten)
• Children (K-2nd grade)
• Children (3rd-5th grade)
• Children (middle school)
• Children (high school)
• Adults
• College
• Elderly
• Physical Disabilities
• Other (please explain below)

If you selected "Other" in above question, please explain.

Purpose of your event and why TheraPets are requested *

Will other animals be in attendance? If yes, please explain. *

Preferred Species* of TheraPet (choosing species other than dog does not guarantee availability) *

• Dogs
• Cats
• Rabbit/Guinea Pig
• Bird
• ANY Animal

Preferred Number* of TheraPets for Event (choice does not guarantee availability) * - Select an option - 1-2 2-4 3-5 5+

Estimated Number of Attendees *

Special Requirements *

---

Event Location Information

Location (including details re: building/room number, etc.) *

Address *

City, State, Zip *

Free Parking Information (location, passes required, etc.) *

Is your event scheduled to take place indoors or outdoors? *

• Indoors
• Outdoors

If outdoor visit, please describe shelter available to volunteers and alternate plans in case of inclement weather.

---

The ARL relies on contributions to help fund our TheraPets program. Can a monetary donation be made for this visit? * - Select an option - Yes No Maybe

Please provide any additional details we should know about your event! *

How did you hear about ARL TheraPets? * - Select an option - ARL Website Social Media TV Attended TheraPets Event ARL Staff TheraPets Community Partner ARL/TheraPets Volunteer Other

---

While we try to accommodate events the best we can, demand for services sometimes exceeds our capacity to satisfy all requests.
Please keep this in mind when submitting your request.