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Apply for a Guide Dog Now!

This application is for people who are blind or visually impaired, and want to apply for a Guide Dog from our program.

Instructions:
Complete the brief inquiry form below. This will serve as notification to our Student Services Team that you are interested in completing an application. A member of our staff will call you and review the next steps in this process.

Application Steps:
1. Complete the application inquiry below.

2. A member of our team will contact you by phone and verify your contact details are correct. The remainder of the application form will be sent to you via email. You will be asked to enter a 6-digit code that is emailed to you to access this form. Additional information about form completion will be provided by our team

3. Once you complete the full application form, there are several additional steps needed. These include a phone interview, video submissions and forms completed by your physicians. Our team will review these in detail with you as well.

Requirements Overview:
There are several requirements to establish eligibility for our guide dog program. Please review these key requirements below.

1. Visual acuity: diagnosed as legally blind in both eyes. Legal blindness must be your best corrected visual acuity.

2. Independent travel: possess the ability to navigate routine travel routes on your own. Applicants should have a minimum of three routes that an applicant traverses independently, on a regular basis.

3. Orientation & Mobility Training: completed O&M training and have both developed and practiced fundamental independent travel skills.

For a full list of program requirements, please navigate to the Program Requirements page of the website or click here.

If you have any questions or concerns, please reach out to our
Student Services Manager at dlarsen@gddca.org.

First Name

Last Name

Date of BirthEnter the 4 digit year, the 2 digit month and 2 digit date separated with the - symbol

Email Address

Confirm Email Address

Phone *

Street Address

Apartment, suite, etc

City *

State/Province

ZIP / Postal Code

Country

Applicant Information

First Name

Last Name

Street Address *

Apartment, suite, etc

City

State

ZIP / Postal Code

Country

Phone *

Confirm Phone Number *

Email Address *

Confirm Email Address *

Age *

Date of Birth *

Gender *MaleFemaleNon-binary

Are you a U.S. Citizen?YesNo

Are you a veteran?YesNo

If yes, which service?

Emergency Contact Information

Emergency Contact Name *

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Emergency Contact Phone *

Emergency Contact Secondary Phone

Emergency Contact Email Address *

Education & Community Involvement

Highest level of educationElementary SchoolHigh SchoolSome CollegeCollege GraduatePost Graduate

Please list any special degrees or training

What community organizations or activities relating to blindness are you involved with, if any?

Have you ever been convicted of a felony? *YesNo

If yes, please explainGuide Dogs of the Desert considers applications from individuals with felony convictions on a case-by-case basis.

General Health

Your height

Your weight

Have you been declared legally blind (acuity of 20/200 or less than 20-degree field in the better eye) by an ophthalmologist or optometist?YesNo

In what year did you become legally blind?

What is the cause of your blindness?

Please describe your residual vision.

Please list any surgeries you've had

Do you suffer with any of the following? (Check all that apply)CoordinationSpasticityReduced StaminaBrittle BonesChronic PainSpeech ImpairmentDepressionHeat / Cold SensitivityDeafnessAllergiesBalance ProblemsLimited MobilityMuscular WeaknessParalysisFrequent HeadachesMemory LossHeightened EmotionsSkin SensitivityHearing LossOther

Do you use any of the following? (Check all that apply)ProsthesisWalkerWhite CaneLeg BraceCrutchManual wheelchairAssistance DogLow Vision AidsWrist BraceSupport CaneHuman GuideHearing AidOther

Are you or a family member allergic to dogs?YesNo

Do you now or have you ever had a substance abuse problem?YesNo

Do you or have you ever had seizures?YesNo

Date of last seizure

Do you have diabetes? If yes, please have your physician complete the diabetic reportYesNo

Are you insulin dependent?YesNo

Do you have any other physical limitations or special needs?

If yes, please explain

Do you now or have you ever had mental health challenges requiring therapy or medication?YesNo

If yes, please explain

Rehabilitation Training & Travel Routine

Do you routinely travel independently?YesNo

Do you consider yourself a confident traveler?YesNo

Primary method of travel

Are you able to walk independently for 1/2 to 1 mile, including street crossings?YesNo

On average, how many blocks do you walk independently every day?

Have you received orientation & mobility (O&M) instruction (white cane training), including both indoor and outdoor with street crossings?YesNo

If yes, when was your training completed?

Destinations

Please provide three purposeful, independent routes you currently use on a regular basis. Your routes should give us an idea of your level of independence and personal motivation. They will also aid in the transition back home to provide sufficient work for a new Guide Dog. These purposeful routes should include multiple blocks with street crossings. If you have address information for these locations, please also include (example: Home to School at 101 School Avenue)

Destination 1

Destination 2

Destination 3

What obstacles/challenges do you encounter in the areas you frequent?During the phone consultation, please be prepared to discuss these travel routes including any intersections along the way, and how you determine when it is safe to cross streets.

Have you ever attended Guide Dog school?YesNo

Guide Dog School 1

Name of School

When did you attend?

Did you graduate?YesNo

Reason for Return / Retirement

Guide Dog School 2

Name of School

When did you attend?

Did you graduate?YesNo

Reason for Return / Retirement

Guide Dog School 3

Name of School

When did you attend?

Did you graduate?YesNo

Reason for Return / Retirement

How would having a Guide Dog enhance your life?

Home Life Information

With whom do you reside? (self, parents, spouse, roommate)

How many adults reside with you?

Number and ages of children in the home

Name of Spouse / Life Partner

Please describe your house / apartment

How long have you lived at your residenceLess than 6 months6-12 months1-5 yearsMore than 5 years

Do you anticipate a move or lifestyle change within the next year?YesNo

If yes, please explain

Please describe your neighborhood

Do you encounter stray or loose dogs, aggressive dogs (restricted or behind fences), small animals (squirrels, rabbits etc)?YesNo

If yes, please explain

Do you now, or have you ever had dogs as pets?YesNo

Please list any other pets

Occupation

Are you currently employed?YesNo

Occupation before blindness?

Occupation after blindness

Current employer

Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Supervisor's Name

Employer's phone number

What accommodations are available for a Guide Dog at your workplace? (i.e. where will the dog be during work hours?)

If you are not employed, what is your present means of support?

Current Annual Income Level$10,000-$20,000$20,000-$30,000$30,000-$40,000$40,000 or more

Personal & Professional References

Personal Reference 1

Name and Relationship to Applicant

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone

Email Address (this is how we contact references)

Personal Reference 2

Name and Relationship to Applicant

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone

Email Address (this is how we send the personal reference form)

Personal Reference 3

Name and Relationship to Applicant

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone

Email Address (this is how we send the personal reference form)

Orientation & Mobility Instructor

Orientation & Mobility Instructor Name

Orientation & Mobility Instructor Phone Number

Orientation & Mobility Instructor Email Address

What was the date of your last Orientation & Mobility Instructor?

Text

Blind Services & Rehabilitation Counselor

Name

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Phone

Email Address

What was the name and reason for your last interaction with your blind services / rehab counselor?

Stay up to dateYes, please add me to your email newsletter so I can get the ‘lowdown’ on what’s happening at GDD!

Agreement

I do hereby apply to Guide Dogs of the Desert for a Guide Dog. I have read the information on the website explaining the program and its requirements. I am prepared for the responsibilities of class training and for the handling / caring of a Guide Dog. To assist Guide Dogs of the Desert in determining whether or not I qualify for the use and care of a Guide Dog, I declare the information I have provided is accurate to the best of my knowledge. Any misrepresentation or false statements provided throughout the admissions process can be considered grounds for rejection of an application to Guide Dogs of the Desert.YesNo

I understand that Guide Dogs of the Desert will record and file information submitted with my application. I understand that this information will be filed electronically in a database created by Pentagon Computers and maintained by Guide Dogs of the Desert staff. My submission of this application indicates my consent for my personal and protected information to be stored via electronic record keeping.AgreeDisagree

Equal Opportunity Organization

Guide Dogs of the Desert is an equal opportunity employer and school. We consider applications for all positions and Guide Dog mobility training, without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation or any other legally protected status. We also support a drug free atmosphere.

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Copyright ©2025. All rights reserved. Guide Dogs of the Desert is a US non-profit organization under IRS section 501(c3). Tax ID #: 23-7296531

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About
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Volunteer
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Guide Dogs
Support K9
Store
Contact

For a full list of program requirements, please navigate to the Program Requirements page of the website or click here.

If you have any questions or concerns, please reach out to ourStudent Services Manager at dlarsen@gddca.org.

Applicant Information

Emergency Contact Information

If you have any questions or concerns, please reach out to our
Student Services Manager at dlarsen@gddca.org.