Application to Raise a Guide Dog Puppy

* Name:

* Address:

* City:

* State: * ZIP Code:

* Home Phone:

Work Phone:

Cell Phone:

Fax:

* Email:

Home Environment: CitySuburbanRural

Name of Parent (if applicant is under 18 years of age):

Are there children in the home? YesNo

Children's Ages (if any):

1. How did you hear of the puppy raising program?

2. Have you ever raised a dog before? YesNo

3. Have you ever raised a dog for the blind? YesNo
If so, what became of it?

4. If you have a pet/pets, please give type, dog breeds, ages:

5. Do you have a fenced yard or enclosed area to relieve the puppy? YesNo

6. Do you agree to allow the puppy to live in your house and sleep in your bedroom? YesNo

7. When are you available to receive a puppy? (There is usually a 6 month wait.)

8. Breed Preference?: Golden Retriever Labrador Retriever Standard Poodle

9. Gender Preference: MaleFemaleNo Preference

The puppy raiser is responsible for providing a loving atmosphere and socialization and for teaching the puppy appropriate house behavior. The approximate cost to the raiser is $500.00. This cost is considered a donation and may be tax-deductible.

Please check each checkbox to agree to the conditions.

* I agree to pay for normal veterinary expenses.

* 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.

* I agree to participate in Puppy Raising and School events 8 times per year. There are also mandatory puppy training days.

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 Desert the 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.

* I Understand: