Puppy Raiser Application Thank you for your interest in becoming a Guide Dogs of the Desert Puppy Raiser. Please fill out the application below so that we can get started. Questions? Please contact us at: (760) 329-6257 or Info@GDDCA.org. Puppy Raiser ApplicationSection 1First Name *Last Name *Street Address *Apartment, suite, etcCity *State *ZIP / Postal Code *Mobile Phone *Home PhoneEmail Address *Confirm Email Address *Is applicant under the age of 18? *YesNoSection 2Would you like to be a puppy raiser, breeder host or foster parent? *Puppy RaiserBreeder HostFoster ParentCheck all that applyDescribe your home areaSelect oneSuburbanCityRuralAre there children in the home?YesNoAges of children *Do you have pets? *YesNoDo you have a fenced yard or enclosed area to relieve the puppy? *YesNoDo you agree to allow the puppy to live in your house and sleep in your bedroom?YesNoSection 3Do you own or rent your home? *OwnRentIf you rent your home, can you provide approval to raise a puppy from property management? *YesNoIf you own your home, and you have an HOA, do they allow dogs over 20 pounds? *YesNoNot applicableIf you plan to take the puppy to work with you, can you provide approval from your supervisor? *YesNoBreed preference? *Labrador RetrieverStandard PoodleNo PreferenceGender Preference? *MaleFemaleNo preferenceWhat date are you available to receive a puppy? (usually there is a 6 month wait) *Section 4The puppy raiser is responsible for providing a loving atmosphere, socialization opportunities, and for teaching the puppy appropriate house behavior. The approximate cost to the raiser is $1,000.00. This cost is considered a donation and may be tax-deductible. We provide veterinary services withing 30 miles of our campus in Whitewater, CA. We have a reimbursement process for approved veterinary services such as emergency visits and normal veterinary expenses outside of the 30-mile radius.Checking the box next to each statement below signifies your acknowledgement and agreement with these statements.Financial Commitment *Do you agree to pay for normal pet care expenses, and do you agree to pay for reimbursable veterinary expenses as needed? Ownership * I understand and agree this puppy shall remain the property of Guide Dogs of the Desert and I agree to return the puppy to Guide Dogs of the Desert as requested for evaluation, neutering and when the puppy is needed for training. Puppy Raiser Information * I have read and agree to the conditions outlined in the attached copy of “Puppy Raiser Information.” Participation *I agree to participate in Puppy Raising and School events 8 times per year. There are also mandatory puppy training days. Section 5Reference 1Name *Street AddressApartment, suite, etcCityStateZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweEmail Address *Phone *Relationship *Reference 2Name *Street AddressApartment, suite, etcCityStateZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweEmail Address *Phone *Relationship *Puppy Raising Agreement *Guide Dogs of the Desert provides inoculations and worming if you bring the puppy to the training facility. If puppies are not considered for breeding stock, Guide Dogs of the Desert will reimburse for neutering up to $75.00 or provide for neutering by our own veterinarian. Guide Dogs of the Desert will provide occasional boarding at the training facility, including boarding of females in season. I understand that while raising a puppy is fun, it is also a job and that I must abide by the rules of raising a guide dog puppy as set forth by Guide Dogs of the Desert. Guide Dogs of the Desert has the right to re-home puppies if guidelines are not followed. Please type applicant's full name *Typing my name in the form above acknowledges that I have read and understood the information included in this application- and that al information is accurate to the best of my knowledge.Please type full name of parent or guardian *Typing my name in the form above acknowledges that I have read and understood the information included in this application- and that al information is accurate to the best of my knowledge.Stay up to date!Yes, please add me to your email newsletter so I can get the ‘lowdown’ on what’s happening at GDD! Form SectionSend MessageSave as Draft
