Guide Dog Interest Form

    Instructions

    To begin an application for a Guide Dog, please fill out and submit the form below.

    Upon completion of this form you will be emailed directions on how to log in to our Online Application Portal to provide additional application material. 

    If you do not see an email from Applications@GuideDog.org after a few minutes, please check your spam/junk folder.

     
    Contact Information
    Name
    Address
    Mailing Address
    Mailing Address
    Mailing Address
    Email
    Email Address
    Phone Numbers
    Primary and Mobile Numbers
    Demographics
    Demographics
    Birthdate (Month, Day, Year)
    Birthdate (Month, Day, Year)
    Hispanic/Latino (optional):
    Hispanic/Latino (optional):
    Are you legally blind?
    Are you legally blind?
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